Individual
MARTHA HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 W EVERGREEN PKWY, ELKHORN, WI 53121-4095
(262) 475-5684
Mailing address
822 HEATHER DR, ELKHORN, WI 53121-1193
(262) 723-1345
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2002-124
WI
Other
Enumeration date
04/14/2021
Last updated
07/14/2022
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