Individual
JESSICA MARIE HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 PEINE RD, WENTZVILLE, MO 63385-2605
(636) 327-3800
(636) 327-8611
Mailing address
1 CAMPUS DR, WENTZVILLE, MO 63385-3415
(636) 327-3800
(636) 327-8611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0451888
MO
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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