Individual
MELODY HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4570 SAINT JOHNS AVE, SUITE 3, JACKSONVILLE, FL 32210-1848
(904) 389-5231
Mailing address
4570 ST JOHN AVE, SUITE 3, JACKSONVILLE, FL 32210-1848
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
360358001
—
FL
Enumeration date
04/20/2012
Last updated
04/20/2012
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