Provider Demographics
NPI:1174770739
Name:HASKELL, CHRIS H (MTCM)
Entity type:Individual
Prefix:MS
First Name:CHRIS
Middle Name:H
Last Name:HASKELL
Suffix:
Gender:F
Credentials:MTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 LOWER MAIN ST STE 11
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-1001
Mailing Address - Country:US
Mailing Address - Phone:207-222-3109
Mailing Address - Fax:
Practice Address - Street 1:178 LOWER MAIN ST STE 11
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-1001
Practice Address - Country:US
Practice Address - Phone:207-222-3109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-25
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC292171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist