Provider Demographics
NPI:1235894676
Name:HAUER, ABBY (MC, LAC)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:HAUER
Suffix:
Gender:F
Credentials:MC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W ADAMS ST STE 514
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-5108
Mailing Address - Country:US
Mailing Address - Phone:312-578-9990
Mailing Address - Fax:
Practice Address - Street 1:101 N 1ST AVE STE 2310
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-1902
Practice Address - Country:US
Practice Address - Phone:602-767-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-19536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health