Individual
MS. CHARLENE DIANE HAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6915 113TH ST, SEMINOLE, FL 33772-6221
(727) 391-0660
Mailing address
PO BOX 8628, SEMINOLE, FL 33775-8628
(727) 391-0660
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA38278
FL
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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