Organization
TAMMI VACHA HAASE PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMMI VACHA-HAASE PHD (CEO/PRESIDENT)
(970) 689-6868
Entity
Organization
Contact information
Practice address
2553 BARRY LN, FORT COLLINS, CO 80524-9366
(970) 689-6868
(970) 472-9381
Mailing address
1236 E ELIZABETH ST, SUITE 2, FORT COLLINS, CO 80524-4000
(970) 488-1668
(970) 472-9381
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08489521
—
CO
01
—
CJ8674
MEDICARE RR
CO
Enumeration date
08/31/2006
Last updated
04/29/2013
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