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General NPI Number Information
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NPI Number | 1013118827
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Entity Type | Individual
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Provider Name | ROBERT BRUCE HAYNES MA, LPC
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Gender | Male
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 2001A LINCOLN DRIVE WEST
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 609-417-7300
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Fax | 856-988-2998
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Provider Business Mailing Address
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Address Line | 2255 OLD MARLTON PIKE EAST
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City | MARLTON
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State | NJ
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Zip | 08053-2666
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Country | US
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Telephone | 609-417-7300
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Fax | 856-988-2998
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC000421
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License Number State | NJ
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