Provider Demographics
NPI:1881954014
Name:HAUSMAN, DONNA MARIE
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:MARIE
Last Name:HAUSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 FOREST FROST ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-0615
Mailing Address - Country:US
Mailing Address - Phone:702-818-0804
Mailing Address - Fax:
Practice Address - Street 1:7127 FOREST FROST ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-0615
Practice Address - Country:US
Practice Address - Phone:702-818-0804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-22
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV455220122104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker