| Doctor Name: | JEFFREY EMIL HAYNES |
| NPI Number: | 1023463908 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 4704203472 |
| Business Practice Address: | 38855 Hills Tech Dr Ste 200 Farmington Hills, MI - 483313428 |
| Business Phone Number: | 2487454900 |
| Business Fax Number: | 2489944616 |
| Mailing Address: | 250 S Tilden St, PONTIAC |
| State: | MI |
| Postal Code: | 483411863 |
| Phone Number: | 2487454900 |
| Fax Number: | 2489944616 |
| NPI Enumeration Date: | 04/28/2016 |
| NPI Last Update Date: | 04/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | 4704203472 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |