Individual
KELLY TAN-HAASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
B1-0000787
DE
103T00000X
Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015467782
BLUE CROSS
DE
01
—
178385
COMPSYCH
DE
01
—
2650058
CIGNA
DE
05
—
922801200
—
MD
Enumeration date
09/08/2008
Last updated
04/28/2009
Update your record
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