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Individual

MILES ERIC HAAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
415 N RICHARD JACKSON BLVD STE 204, PANAMA CITY BEACH, FL 32407-3694
(917) 399-3094
Mailing address
469 PARADISE BLVD, PANAMA CITY BEACH, FL 32413-8726
(917) 399-3094

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker
17943
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119357400
FL
01
17943
STATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
02/26/2021
Last updated
10/20/2023
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