Individual
DR. JACK PHILLIP HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
36700 WOODWARD AVE, SUITE 30, BLOOMFIELD HILLS, MI 48304-0926
(248) 642-4545
Mailing address
36700 WOODWARD AVE, SUITE 30, BLOOMFIELD HILLS, MI 48304-0926
(248) 642-4545
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
63301001358
MI
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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