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General NPI Number Information
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NPI Number | 1023354990
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Entity Type | Individual
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Provider Name | JENNINGS B. HAYNES PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 01/30/2018
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Provider Practice Location Address
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Address Line | 2431 E GLENN AVE STE 400
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City | AUBURN
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State | AL
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Zip | 36830-6419
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Country | US
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Telephone | 334-377-4900
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Fax | 334-377-4901
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Provider Business Mailing Address
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Address Line | 2431 E GLENN AVE STE 400
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City | AUBURN
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State | AL
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Zip | 36830-6419
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Country | US
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Telephone | 334-377-4900
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Fax | 334-377-4901
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1951
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License Number State | AL
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