MEDICARE: RACHEL HAACK MFT-I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1871262378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL HAACK MFT-I

Provider Business Mailing Address
First Line	:	3732 LAKESIDE DR STE 100
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-4590
Country	:	US
Telephone Number	:	775-870-6552
Fax Number	:

Provider Business Practice Location Address
First Line	:	3732 LAKESIDE DR
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-5278
Country	:	US
Telephone Number	:	775-870-6552
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2021
Last Update Date	:	09/08/2021

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Directions to “ RACHEL HAACK MFT-I” Practice Location

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