MEDICARE: CONNIE HASLER MA, LMFT

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	LMFT-0277	AZ

General Provider Information

NPI Number	:	1881704310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNIE HASLER MA, LMFT

Provider Business Mailing Address
First Line	:	1930 S ALMA SCHOOL RD
Second Line	:	C-107
City	:	MESA
State	:	AZ
Zip	:	85210-3064
Country	:	US
Telephone Number	:	480-929-6192
Fax Number	:

Provider Business Practice Location Address
First Line	:	1930 S ALMA SCHOOL RD
Second Line	:	C-107
City	:	MESA
State	:	AZ
Zip	:	85210-3064
Country	:	US
Telephone Number	:	480-929-6192
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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