Provider Demographics
NPI:1326253824
Name:HAAS, TOMI LYNN (CPHT)
Entity Type:Individual
Prefix:MS
First Name:TOMI
Middle Name:LYNN
Last Name:HAAS
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26283 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:MI
Mailing Address - Zip Code:49065
Mailing Address - Country:US
Mailing Address - Phone:269-624-1471
Mailing Address - Fax:269-624-5704
Practice Address - Street 1:350 N.MAIN ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:MI
Practice Address - Zip Code:49065
Practice Address - Country:US
Practice Address - Phone:269-624-2231
Practice Address - Fax:269-624-5704
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3801-0106-1157-332247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other