Provider Demographics
NPI:1093482135
Name:HAASE, MARIA SUSANNE
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:SUSANNE
Last Name:HAASE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 SE OCEAN BLVD APT 305
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2222
Mailing Address - Country:US
Mailing Address - Phone:786-238-6850
Mailing Address - Fax:
Practice Address - Street 1:50 SE OCEAN BLVD APT 305
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2222
Practice Address - Country:US
Practice Address - Phone:786-238-6850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health