Healthcare Provider Details

I. General information

NPI: 1417408378
Provider Name (Legal Business Name): BARBARA HAIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA LITTLEPAGE

II. Dates (important events)

Enumeration Date: 10/16/2016
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8680 GRATIOT RD STE A
SAGINAW MI
48609-4885
US

IV. Provider business mailing address

304 S NIAGARA ST
SAGINAW MI
48602-1570
US

V. Phone/Fax

Practice location:
  • Phone: 989-272-4346
  • Fax:
Mailing address:
  • Phone: 989-799-6542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801117378
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801117378
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: