Provider Demographics
NPI:1588090260
Name:HAAS, AFTON
Entity type:Individual
Prefix:
First Name:AFTON
Middle Name:
Last Name:HAAS
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 1:312 W 32ND PL
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3010
Mailing Address - Country:US
Mailing Address - Phone:918-241-4633
Mailing Address - Fax:
Practice Address - Street 1:312 W 32ND PL
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-3010
Practice Address - Country:US
Practice Address - Phone:918-241-4633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst