| Doctor Name: | TINA HASKINS |
| NPI Number: | 1124361035 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 10912 |
| Business Practice Address: | 3099 River Rd S Ste 150 Salem, OR - 973029754 |
| Business Phone Number: | 5035811567 |
| Business Fax Number: | 5034852590 |
| Mailing Address: | 4751 49th Ave Ne, SALEM |
| State: | OR |
| Postal Code: | 973053302 |
| Phone Number: | 5033908520 |
| Fax Number: | |
| NPI Enumeration Date: | 03/28/2013 |
| NPI Last Update Date: | 04/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 10912 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |