Doctor Name: | MRS. ROXANNE HAYNES |
NPI Number: | 1104159532 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | 6801088453 |
Business Practice Address: | 6549 Town Center Dr Suite A Clarkston, MI - 483464824 |
Business Phone Number: | 2486206400 |
Business Fax Number: | 2486206405 |
Mailing Address: | 49061 South Interstate 94, Apt 106 BELLEVILLE |
State: | MI |
Postal Code: | 48111 |
Phone Number: | 4702557723 |
Fax Number: | |
NPI Enumeration Date: | 09/17/2009 |
NPI Last Update Date: | 03/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 6801088453 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |