Provider Demographics
NPI:1851539100
Name:HAFNER, ROBERT J (MHC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:HAFNER
Suffix:
Gender:M
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14875 SW 238TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8702
Mailing Address - Country:US
Mailing Address - Phone:786-236-7927
Mailing Address - Fax:305-257-0040
Practice Address - Street 1:11060 N KENDALL DR
Practice Address - Street 2:STE 7
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1272
Practice Address - Country:US
Practice Address - Phone:786-236-7927
Practice Address - Fax:305-257-0040
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-24
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7474101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health