Provider Demographics
NPI:1124383864
Name:HAUBERT, ANNE MARIE (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:HAUBERT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CIDER MILL RD
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-3807
Mailing Address - Country:US
Mailing Address - Phone:860-508-1889
Mailing Address - Fax:
Practice Address - Street 1:1750 ELLINGTON RD
Practice Address - Street 2:BUILDING 3
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2746
Practice Address - Country:US
Practice Address - Phone:860-508-1889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001526106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist