Provider Demographics
NPI:1699219030
Name:HAEFELE - HARPER, ASHLEY ANN
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:HAEFELE - HARPER
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 1:3339 KETTERING RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2317
Mailing Address - Country:US
Mailing Address - Phone:989-525-3774
Mailing Address - Fax:
Practice Address - Street 1:2838 AUTOMOTIVE CTR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1220
Practice Address - Country:US
Practice Address - Phone:989-790-7500
Practice Address - Fax:989-790-8037
Is Sole Proprietor?:No
Enumeration Date:2016-12-05
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011097301041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical