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Individual

JUSTICE MERRY LYNN HAYNES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
618 S ALDER ST, MOSES LAKE, WA 98837-1760
(509) 764-6644
Mailing address
804 S BARBARA AVE, MOSES LAKE, WA 98837-2719
(509) 793-6737

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
WA

Other

Enumeration date
05/19/2021
Last updated
05/19/2021
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