Individual
JASON R HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NCC
Contact information
Practice address
3754 LAVISTA RD STE 200, TUCKER, GA 30084-5627
(770) 810-5789
Mailing address
825 HIGHLAND LN NE APT 1206, ATLANTA, GA 30306-4338
(404) 314-4834
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/04/2020
Last updated
01/04/2020
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