Healthcare Provider Details

I. General information

NPI: 1457680936
Provider Name (Legal Business Name): CHARLOTTE CAROLYN HAAS CD(DONA)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2009
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6107 W LISBON AVE
MILWAUKEE WI
53210-2125
US

IV. Provider business mailing address

PO BOX 1637
MILWAUKEE WI
53201-1637
US

V. Phone/Fax

Practice location:
  • Phone: 414-807-6785
  • Fax:
Mailing address:
  • Phone: 414-807-6785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: