Individual
TERRA J HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
707 F ST, RUPERT, ID 83350-1638
(208) 794-8139
Mailing address
523 S MAPLE ST, RUPERT, ID 83350-2168
(208) 794-8139
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/24/2022
Last updated
06/24/2022
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