Provider Demographics
NPI:1609097187
Name:HABER, REBECCA (MS, HIS)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:
Last Name:HABER
Suffix:
Gender:F
Credentials:MS, HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S. MILTON ROAD
Mailing Address - Street 2:SUITE # 205
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001
Mailing Address - Country:US
Mailing Address - Phone:928-214-7114
Mailing Address - Fax:928-226-1387
Practice Address - Street 1:1300 S. MILTON ROAD
Practice Address - Street 2:SUITE # 205
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001
Practice Address - Country:US
Practice Address - Phone:928-214-7114
Practice Address - Fax:928-226-1387
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD4230237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist