Most Relevant Information
Provider Data
| NPI Number: | 1003022526 |
| Provider Name: | ROBERT THAYNE HAKE |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | CATC# 071372 |
Most Important Dates
| Enumeration Date: | 05/14/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1120 S DORA ST
UKIAH
CA
954826340
Practice Location Phone/Fax
| Phone: | 7074722627 |
| Fax: |
Provider Mailing Location
1120 S DORA ST
UKIAH
CA
954826340
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |