Individual
TONYA HAASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
744 CONCORD DR, CRYSTAL LAKE, IL 60014-1820
(847) 414-4315
Mailing address
744 CONCORD DR, CRYSTAL LAKE, IL 60014-1820
(847) 414-4315
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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