Healthcare Provider Details

I. General information

NPI: 1174034698
Provider Name (Legal Business Name): JENNIFER MARY HAUSER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 N BROADWAY ST # 200
AKRON OH
44308-1910
US

IV. Provider business mailing address

1178 AYCLIFFE LN
CUYAHOGA FALLS OH
44221-5580
US

V. Phone/Fax

Practice location:
  • Phone: 330-535-8181
  • Fax:
Mailing address:
  • Phone: 858-220-4421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY31695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: