Provider Demographics
NPI:1962710822
Name:HAASE, MARION (MM, MT-BC)
Entity type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:HAASE
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11112 HAPPY ACRES LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4519
Mailing Address - Country:US
Mailing Address - Phone:813-317-9500
Mailing Address - Fax:
Practice Address - Street 1:11112 HAPPY ACRES LN
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4519
Practice Address - Country:US
Practice Address - Phone:813-317-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist