Individual
TARA MONE'T IVERSON-HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 GRAPHIC ARTS RD STE 100, EMPORIA, KS 66801-6204
(620) 481-7140
(620) 208-6488
Mailing address
420 KENNEDY ST, BURLINGTON, KS 66839-1120
(620) 208-6480
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1514
KS
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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