Provider Demographics
NPI:1417229709
Name:HAAS, KAREN (LMT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:
Last Name:HAAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:498 MAIN ST.
Mailing Address - City:FAIR HAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:13064-0532
Mailing Address - Country:US
Mailing Address - Phone:315-591-7847
Mailing Address - Fax:
Practice Address - Street 1:498 MAIN ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:NY
Practice Address - Zip Code:13156
Practice Address - Country:US
Practice Address - Phone:315-591-7847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024754225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist