Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 401 | KS |
NPI | 1003220831 |
---|---|
Provider Name | Janet Haynes |
First Address | Newton, KS 67114-2206 |
Second Address | Topeka, KS 66607-2354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 19/06/2014 |