Provider Demographics
NPI:1194565358
Name:HAUCK, ESTHER FAYGE (MFT)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:FAYGE
Last Name:HAUCK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 NE 183RD ST APT 404E
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2137
Mailing Address - Country:US
Mailing Address - Phone:310-686-8743
Mailing Address - Fax:
Practice Address - Street 1:19790 W DIXIE HWY STE 1208
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2548
Practice Address - Country:US
Practice Address - Phone:310-686-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT4151106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist