Mary Kelly Haack is a Clinical in Minneapolis, Minnesota. Mary Kelly Haack practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Kelly Haack is 1336336254. The last update date is 2013-12-31.
Mary Kelly Haack's current location address is 3333 University Avenue Se, Minneapolis, Minnesota. You can contact this provider via phone number 6127285399 and fax number 6127285301. The mailing address for Mary Kelly Haack is 3333 University Avenue Se, Minneapolis, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Kelly Haack |
|---|---|
| Address | 3333 University Avenue Se, Minneapolis, Minnesota |
| Phone Number | 6127285399 |
| Fax Number | 6127285301 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1336336254 |
|---|---|
| Provider Enumeration Date | 2007-09-25 |
| Last Updated Date | 2013-12-31 |
Provider Mailing Address Detail
| Address | 3333 University Avenue Se |
|---|---|
| City | Minneapolis |
| State | Minnesota (MN) |
| Post Code | 55414 |
| Phone Number | 6127285399 |
| Fax Number | 6127285301 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | LP5023 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10025287200 | NE | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Mary Kelly Haack by the Centers for Medicare & Medicaid Services?
The Mary Kelly Haack has been assigned the NPI (National Provider Identifier) 1336336254 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Mary Kelly Haack's physical address?
The Mary Kelly Haack is physically located at 3333 University Avenue Se, in the city of Minneapolis, MN, with the postal code 55414.
What is Mary Kelly Haack's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Mary Kelly Haack is Clinical, and the taxonomy code that classifies this field of practice is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1336336254 to Mary Kelly Haack?
The Centers for Medicare & Medicaid Services originally issued the 1336336254 to Mary Kelly Haack on 2007-09-25.
As of what date was the information pertaining to Mary Kelly Haack, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Mary Kelly Haack, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2013-12-31.
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