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NPI Code Detail

MEDICARE: MS. SUSAN ANN HAINES BA

MEDICARE: MS. SUSAN ANN HAINES BA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1871776005
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN ANN HAINES BA
Provider Business Mailing Address
First Line : 6 SOUTHSIDE RD
Second Line :
City : DANVERS
State : MA
Zip : 01923-1409
Country : US
Telephone Number : 978-762-8352
Fax Number :
Provider Business Practice Location Address
First Line : 6 SOUTHSIDE RD
Second Line :
City : DANVERS
State : MA
Zip : 01923-1409
Country : US
Telephone Number : 978-762-8352
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2007
Last Update Date : 08/17/2012

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