Individual
JESSICA CHRISTINA HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
908 WASHINGTON ST, RAVENSWOOD, WV 26164-1143
(304) 531-9678
Mailing address
203 WILSON ST, RAVENSWOOD, WV 26164-1533
(304) 531-9678
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-9104
WV
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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