Basic Information
Provider Information
NPI: 1770917395
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAUN
FirstName: TAYLOR
MiddleName: ANNE
NamePrefix: MS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 12723
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662822723
CountryCode: US
TelephoneNumber: 9139526696
FaxNumber: 9136492562
Practice Location
Address1: 8906 W 97TH ST
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662124014
CountryCode: US
TelephoneNumber: 9139526696
FaxNumber: 9136492562
Other Information
ProviderEnumerationDate: 08/30/2013
LastUpdateDate: 10/22/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X8874KSY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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