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General NPI Number Information
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NPI Number | 1073553772
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Entity Type | Individual
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Provider Name | MICHAEL HANEY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 1600 W. 38TH STREET SUITE 306
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City | AUSTIN
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State | TX
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Zip | 78731-6406
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Country | US
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Telephone | 512-451-9891
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 W. 38TH STREET SUITE 306
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City | AUSTIN
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State | TX
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Zip | 78731-6406
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Country | US
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Telephone | 512-451-9891
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 24445
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License Number State | TX
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