| NPI | 1548308919 | 
|---|---|
| Former Name | MIRACLE RAYE HAASE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 537-9-15-05-254)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 01726)  | 
| Enumeration Date | 2007-02-01 | 
| Last Update Date | 2024-11-22 |