Healthcare Provider Details

I. General information

NPI: 1962756627
Provider Name (Legal Business Name): BARBARA HOVEN-HAFDAHL LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2012
Last Update Date: 11/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 SE 124TH AVE
VANCOUVER WA
98684-6015
US

IV. Provider business mailing address

108 SE 124TH AVENUE
VANCOUVER WA
98684-6015
US

V. Phone/Fax

Practice location:
  • Phone: 360-524-4828
  • Fax: 360-885-4944
Mailing address:
  • Phone: 360-524-4828
  • Fax: 360-885-4944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH60302035
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: