Individual
DR. DIANA L HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1761 M 139, BENTON HARBOR, MI 49022-6101
(269) 934-0424
(269) 934-0570
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004811
MI
152WC0802X
Corneal and Contact Management Optometrist
046-008855
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811065469
—
MI
Enumeration date
12/01/2006
Last updated
04/06/2021
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