| Doctor Name: | KIMBERLY HAAS |
| NPI Number: | 1205220001 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SAC-IT |
| License Number: | 17415-130 |
| Business Practice Address: | 158 S Anderson St Suite 3 Rhinelander, WI - 545013447 |
| Business Phone Number: | 7153697300 |
| Business Fax Number: | 7153697301 |
| Mailing Address: | 6400 Industrial Loop, GREENDALE |
| State: | WI |
| Postal Code: | 531292452 |
| Phone Number: | 4144234100 |
| Fax Number: | 4144234134 |
| NPI Enumeration Date: | 03/19/2015 |
| NPI Last Update Date: | 03/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 17415-130 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |