Individual
MARY HELEN HAISTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 E 10TH ST, NEW ALBANY, IN 47150-3220
(502) 741-8589
Mailing address
601 E 10TH ST, NEW ALBANY, IN 47150-3220
(502) 741-8589
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
222Q00000X
222Q00000X DEVELOPMENTAL THERAPIST
IN
Enumeration date
07/06/2019
Last updated
07/06/2019
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