Individual
MS. TONI FAYE HAITHCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1615 E 13 MILE RD APT 205, MADISON HEIGHTS, MI 48071-5020
(586) 604-6585
Mailing address
PO BOX 71732, MADISON HEIGHTS, MI 48071-0732
(586) 604-6585
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
812626
—
133NN1002X
Nutrition Education Nutritionist
812626
—
133V00000X
Registered Dietitian
Primary
812626
—
Other
Enumeration date
08/03/2009
Last updated
04/30/2015
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