Individual
KATHRYN S HAASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1418 MORNINGSIDE DR NE, ALBUQUERQUE, NM 87110-5640
(505) 359-9295
Mailing address
PO BOX 30103, ALBUQUERQUE, NM 87190-0103
(505) 359-9295
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1347
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J 9813
—
NM
Enumeration date
04/03/2007
Last updated
06/22/2012
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