Basic Information
| Provider Information | |||||||||
| NPI: | 1306321617 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HALLAUER | ||||||||
| FirstName: | CALEB | ||||||||
| MiddleName: | JOHN | ||||||||
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| Credential: | MA, T-LMLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 212 NW REDBUD CIR APT 2 | ||||||||
| Address2: | |||||||||
| City: | TOPEKA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 666171898 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7852369703 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2619 W 6TH ST STE C | ||||||||
| Address2: | |||||||||
| City: | LAWRENCE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660494300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858308299 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2018 | ||||||||
| LastUpdateDate: | 10/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 2880 | KS | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.