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General NPI Number Information
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NPI Number | 1356494538
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Entity Type | Individual
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Provider Name | AMBER LYNN HAINES LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 02/05/2019
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Provider Practice Location Address
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Address Line | 55 NORTH RD STE 220
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City | BEDFORD
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State | MA
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Zip | 01730
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Country | US
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Telephone | 781-825-5714
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Fax | 781-275-1770
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Provider Business Mailing Address
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Address Line | 55 NORTH RD STE 220
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City | BEDFORD
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State | MA
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Zip | 01730-1078
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Country | US
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Telephone | 781-825-5714
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Fax | 781-275-1770
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 114880
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License Number State | MA
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