Provider Demographics
NPI:1366089245
Name:DAVIS, HASKIN AARON (MSW, RCSWI)
Entity type:Individual
Prefix:
First Name:HASKIN
Middle Name:AARON
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MSW, RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 WINTER WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1955
Mailing Address - Country:US
Mailing Address - Phone:407-740-5655
Mailing Address - Fax:407-740-0372
Practice Address - Street 1:2256 WINTER WOODS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1955
Practice Address - Country:US
Practice Address - Phone:407-740-5655
Practice Address - Fax:407-740-0372
Is Sole Proprietor?:No
Enumeration Date:2019-12-10
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW12748104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker