Individual
TRACY LYNN HAAKENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
981 HIGH HOUSE RD STE 100, CARY, NC 27513-3510
(919) 388-0111
(919) 388-8668
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(502) 882-9379
(502) 805-0526
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15602
NC
225XP0200X
Pediatric Occupational Therapist
160
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170647
—
AZ
Enumeration date
12/19/2006
Last updated
12/20/2022
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