Provider Demographics
NPI:1689805848
Name:HAUN, STEPHANIE CHARLENE (MSED)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:CHARLENE
Last Name:HAUN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 SAN IGNACIO AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3072
Mailing Address - Country:US
Mailing Address - Phone:786-348-5711
Mailing Address - Fax:
Practice Address - Street 1:1514 SAN IGNACIO AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3072
Practice Address - Country:US
Practice Address - Phone:786-348-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist