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Individual

MAYRA E. HAYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
2441 CABEZON BLVD SE, RIO RANCHO, NM 87124
(505) 717-1155
(505) 717-1473
Mailing address
2441 CABEZON BLVD SE, RIO RANCHO, NM 87124
(505) 717-1155
(505) 717-1473

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
106H00000X
Marriage & Family Therapist
Primary
0140461
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
766995000
FL
Enumeration date
05/10/2007
Last updated
12/14/2015
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