Individual
MARISSA JEAN HABERLACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1501 N CAMPBELL AVE, TUCSON, AZ 85724-5057
(520) 694-0111
Mailing address
PO BOX 245057, TUCSON, AZ 85724-5057
(520) 626-7233
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19073
CA
207P00000X
Emergency Medicine Physician
R2955
AZ
Other
Enumeration date
05/25/2018
Last updated
09/10/2021
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