Individual
SUSAN CAROL HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1501 SAN PEDRO DR SE, NUTRITION 120, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
1916 SAINT ST NE, ALBUQUERQUE, NM 87112-2715
(612) 810-1778
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2411
MN
Other
Enumeration date
08/31/2012
Last updated
08/01/2013
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