Provider Demographics
NPI:1760711543
Name:HAAS, SUSAN LEIGH (OT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LEIGH
Last Name:HAAS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:HAAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:5606 GENEVA AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-4824
Mailing Address - Country:US
Mailing Address - Phone:806-797-3805
Mailing Address - Fax:806-797-0140
Practice Address - Street 1:601 CREEKSIDE XING STE 106
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-4093
Practice Address - Country:US
Practice Address - Phone:210-804-5400
Practice Address - Fax:210-678-4142
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-08
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist