Individual
MR. JOHN MARK HANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LPC
Contact information
Practice address
4131 SPICEWOOD SPRINGS RD STE O3, AUSTIN, TX 78759-8664
(512) 346-9299
(512) 264-3729
Mailing address
1912 SHADOWBROOK CIR, ROUND ROCK, TX 78681-7139
(512) 388-4172
(512) 264-3729
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
19095
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TX
Enumeration date
06/14/2007
Last updated
07/08/2007
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