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General NPI Number Information
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NPI Number | 1033775960
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Entity Type | Individual
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Provider Name | KATELYN BROOKE HAAGER
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Gender | Female
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 05/16/2019
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Provider Practice Location Address
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Address Line | 5050 MADISON RD
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City | CINCINNATI
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State | OH
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Zip | 45227-1491
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Country | US
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Telephone | 513-272-2800
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Fax | 513-272-2807
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Provider Business Mailing Address
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Address Line | 3001 BELLEWOOD AVE APT 1
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City | CINCINNATI
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State | OH
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Zip | 45213-1634
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Country | US
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Telephone | 765-914-0353
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | S.1900670-TEMP
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License Number State | OH
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