Physician Compare National (NPI:1700972478)

HEALTHCARE PROVIDER: CYNTHIA JANE HAAKANA PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1700972478
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688614688
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050510000218
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAAKANA
	Individual professional last name
Provider First Name	CYNTHIA
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	CP
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4500 PARK GLEN RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 155
	Group Practice or individual's line 2 address
City	ST LOUIS PARK
	Group Practice or individual's city
State	MN
	Group Practice or individual's state
Zip Code	554164888
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y