Individual
LYSSA T HAASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
5770 S 1500 W, SALT LAKE CITY, UT 84123-5216
(801) 313-7770
(801) 313-7771
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
10069932-2501
UT
103T00000X
Psychologist
4573
MT
Other
Enumeration date
01/05/2015
Last updated
08/29/2024
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