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Individual

MS. CHARMAINE THERESA HAYNES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
22505 ALLEN RD, WOODHAVEN, MI 48183-2237
(734) 676-7474
(734) 676-7075
Mailing address
25146 SUPERIOR RD, TAYLOR, MI 48180-4517
(734) 946-4647

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302025564
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302025564
STATE LICENCE
MI
Enumeration date
02/06/2007
Last updated
07/08/2007
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