Individual
TIMOTHY HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
10032 E SOUTHERN AVE, MESA, AZ 85209-2759
(480) 351-2850
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-1661
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
779720
—
AZ
Enumeration date
12/04/2006
Last updated
04/06/2023
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