Provider Demographics
NPI:1821261009
Name:HAAS, ANGELIKA FRANZISKA (MS)
Entity Type:Individual
Prefix:MISS
First Name:ANGELIKA
Middle Name:FRANZISKA
Last Name:HAAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E7475 RAWHIDE RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:WI
Mailing Address - Zip Code:54961-9025
Mailing Address - Country:US
Mailing Address - Phone:920-531-2660
Mailing Address - Fax:
Practice Address - Street 1:E7475 RAWHIDE RD
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:WI
Practice Address - Zip Code:54961-9025
Practice Address - Country:US
Practice Address - Phone:920-531-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37271231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42192600Medicaid