Individual
LYDIA JEAN HAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1118 TWILIGHT DR, DE PERE, WI 54115-1372
(715) 966-3596
Mailing address
611 BUTLER ST, DE PERE, WI 54115-1203
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3537-226
WI
103TC0700X
Clinical Psychologist
Primary
5213-17
WI
Other
Enumeration date
09/12/2017
Last updated
06/12/2024
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