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General NPI Number Information
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NPI Number | 1568100295
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Entity Type | Organization
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Legal Business Name | LINDSEY D HAINES
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 719 RUIDOSA DOWNS
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City | HELOTES
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State | TX
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Zip | 78023-4640
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Country | US
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Telephone | 210-687-2138
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Fax |
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Provider Business Mailing Address
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Address Line | 719 RUIDOSA DOWNS
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City | HELOTES
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State | TX
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Zip | 78023-4640
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDSEY HAINES
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Credential | LCDC, LPC
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Telephone | 210-687-2213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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