| Doctor Name: | MRS. HANEELIA JEAN MAX |
| NPI Number: | 1275706939 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 322 Hwy 160 Suite #13 Tuba City, AZ - 860452489 |
| Business Phone Number: | 9282835206 |
| Business Fax Number: | 9282835733 |
| Mailing Address: | Po Box 2489, TUBA CITY |
| State: | AZ |
| Postal Code: | 860452489 |
| Phone Number: | 9282835206 |
| Fax Number: | 9282835733 |
| NPI Enumeration Date: | 04/02/2008 |
| NPI Last Update Date: | 04/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156F00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |