Individual
MRS. TABITHA STAR HAYNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CFY-SLP
Contact information
Practice address
2221 DILLON RD, RETIREMENT RANCH INC OF CLOVIS, CLOVIS, NM 88101-9454
(575) 762-4495
Mailing address
2437 E 21ST ST UNIT C, CLOVIS, NM 88101-3940
(575) 309-6324
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-4264
NM
Other
Enumeration date
10/09/2008
Last updated
10/09/2008
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