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General NPI Number Information
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NPI Number | 1134771900
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Entity Type | Individual
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Provider Name | LIZA HAAS PHD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 02/28/2021
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Provider Practice Location Address
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Address Line | 1518 WALNUT ST STE 1600
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3409
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Country | US
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Telephone | 215-278-9522
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Fax |
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Provider Business Mailing Address
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Address Line | 1518 WALNUT ST STE 1600
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3409
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Country | US
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Telephone | 215-278-9522
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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 | PS018818
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License Number State | PA
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