Individual
MISTY MICHELLE HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
2424 W MAIN ST, RUSSELLVILLE, AR 72801-2531
(479) 967-4673
(479) 967-7140
Mailing address
5537 BLEAUX AVE, SPRINGDALE, AR 72762-0737
(479) 872-5580
(479) 872-5581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/23/2010
Last updated
02/23/2010
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