Individual
MOLLIE HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5330 DR MARTIN LUTHER KING JR BLVD, ANDERSON, IN 46013-6600
(765) 606-4995
Mailing address
5330 DR MARTIN LUTHER KING JR BLVD, ANDERSON, IN 46013-6600
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46031
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300035406
—
IN
Enumeration date
11/25/2020
Last updated
11/25/2020
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