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General NPI Number Information
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NPI Number | 1932100864
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Entity Type | Organization
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Legal Business Name | HAAG MENTAL HEALTH CONSULTING, INC.
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 415 N MAIN ST SUITE 3
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City | POYNETTE
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State | WI
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Zip | 53955-8963
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Country | US
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Telephone | 605-635-2146
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Fax |
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Provider Business Mailing Address
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Address Line | 415 N MAIN ST SUITE 3
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City | POYNETTE
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State | WI
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Zip | 53955-8963
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Country | US
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Telephone | 605-635-2146
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. VELMA HAAG
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Credential |
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Telephone | 608-635-2146
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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 | 2017-123
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License Number State | WI
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