Provider Demographics
NPI:1194509737
Name:HAAKINSON, JULIANA JOSETTE
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:JOSETTE
Last Name:HAAKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52187 E BLACK JACK RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:AZ
Mailing Address - Zip Code:85539-9616
Mailing Address - Country:US
Mailing Address - Phone:162-325-5958
Mailing Address - Fax:
Practice Address - Street 1:6344 E BROWN RD STE 104
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-4843
Practice Address - Country:US
Practice Address - Phone:480-269-0765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician