Individual
BETH HAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1936 THOMAS AVE, SAN DIEGO, CA 92109-4528
(602) 390-5827
Mailing address
1936 THOMAS AVE, SAN DIEGO, CA 92109-4528
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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