Individual
MS. KIMBERLY ANN HAYNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1200 W APACHE ST, FARMINGTON, NM 87401-3886
(505) 258-2763
(505) 675-2803
Mailing address
1200 W APACHE ST, FARMINGTON, NM 87401-3886
(505) 258-2763
(505) 675-2803
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-11810
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61224502
—
NM
Enumeration date
09/13/2016
Last updated
11/01/2023
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