Provider Demographics
NPI:1972722544
Name:ACKER, HASKELL B (PHD)
Entity Type:Individual
Prefix:DR
First Name:HASKELL
Middle Name:B
Last Name:ACKER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92415
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99509-2415
Mailing Address - Country:US
Mailing Address - Phone:907-562-1126
Mailing Address - Fax:907-563-6546
Practice Address - Street 1:4241 B ST STE 301
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5920
Practice Address - Country:US
Practice Address - Phone:907-562-1126
Practice Address - Fax:907-563-6546
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK465103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist