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NPI Code Detail

MEDICARE: JENNIFER HAYNES MHC, MS, LMT

MEDICARE:   JENNIFER  HAYNES  MHC, MS, LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171W00000XContractor227014011IL
2225700000XMassage Therapist
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1912306945
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HAYNES MHC, MS, LMT
Provider Business Mailing Address
First Line : 174 PLEASANT ST APT 2
Second Line :
City : HANSON
State : MA
Zip : 02341-1908
Country : US
Telephone Number : 508-789-0920
Fax Number :
Provider Business Practice Location Address
First Line : 174 PLEASANT ST APT 2
Second Line :
City : HANSON
State : MA
Zip : 02341-1908
Country : US
Telephone Number : 508-789-0920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2014
Last Update Date : 01/08/2020

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Directions to “ JENNIFER HAYNES MHC, MS, LMT” Practice Location

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