Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | XL3540 | ME |
N | 225C00000X | Rehabilitation Counselor | 00110438 | ME |
NPI | 1255634200 |
---|---|
Provider Name | Mrs. Kari R Haugen |
First Address | Portland, ME 04101-3190 |
Second Address | Portland, ME 04101-3190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2010 |
Last Update Date | 14/12/2010 |