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Individual

TRAVIS PAUL HAASE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
413 N ALLUMBAUGH ST, SUITE 101, BOISE, ID 83704-9212
(208) 323-1125
Mailing address
2704 SUNFLOWER DR, NAMPA, ID 83686-7118
(208) 340-6996

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4901
ID

Other

Enumeration date
04/05/2012
Last updated
04/05/2012
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