Doctor Name: | SARAH HAASE |
NPI Number: | 1083063051 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 008246 |
Business Practice Address: | 2795 Main St W Suite 19b Snellville, GA - 30078 |
Business Phone Number: | 7706863908 |
Business Fax Number: | |
Mailing Address: | 1050 Lenox Park Blvd. Apt. 1314, ATLANTA |
State: | GA |
Postal Code: | 30319 |
Phone Number: | 4043751300 |
Fax Number: | |
NPI Enumeration Date: | 06/09/2016 |
NPI Last Update Date: | 06/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 008246 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |