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General NPI Number Information
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NPI Number | 1972244291
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Entity Type | Individual
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Provider Name | HEIDE L HAUSKEN ED.S, NCSP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2022
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 3500 W SCENIC DR
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City | BOISE
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State | ID
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Zip | 83703-4725
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Country | US
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Telephone | 208-340-0930
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 W SCENIC DR
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City | BOISE
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State | ID
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Zip | 83703-4725
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Country | US
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Telephone | 208-340-0930
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | EDUID552776347
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 439884H
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 34419
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License Number State | ID
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