Healthcare Provider Details
I. General information
NPI: 1982790747
Provider Name (Legal Business Name): CHERYL HAUN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/05/2006
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1258 HIGH ST
EUGENE OR
97401-3238
US
IV. Provider business mailing address
1258 HIGH ST
EUGENE OR
97401-3238
US
V. Phone/Fax
- Phone: 541-342-8437
- Fax: 541-342-1639
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: