Individual
MRS. MARIA R. HAISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CD
Contact information
Practice address
600 EAST BLVD, NUTRITIONAL SERVICES, ELKHART, IN 46514-2483
(574) 523-3236
(574) 296-6504
Mailing address
PO BOX 660376, EGH INSURANCE PAYMENTS, INDIANAPOLIS, IN 46266-0376
(574) 523-3148
(574) 523-3492
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37001997A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015831
DIETETIC REGISTRATION
IN
01
—
37001997A
RD LICENSE
IN
Enumeration date
06/07/2010
Last updated
03/01/2011
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