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General NPI Number Information
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NPI Number | 1104110147
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Entity Type | Individual
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Provider Name | TERESA LEE HAEG LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 701 WEST 7TH AVE 107 SUITE A
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City | SPOKANE
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State | WA
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Zip | 99204
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Country | US
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Telephone | 530-910-6571
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Fax | 509-363-2762
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Provider Business Mailing Address
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Address Line | 1225 E 30TH AVE
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City | SPOKANE
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State | WA
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Zip | 99203
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Country | US
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Telephone | 503-910-6571
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Fax | 509-363-2762
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 60126092
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60309126
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License Number State | WA
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