Provider Demographics
NPI:1487073029
Name:HAINES, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HAINES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7225 LONDON BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1182
Mailing Address - Country:US
Mailing Address - Phone:702-466-6137
Mailing Address - Fax:702-586-6645
Practice Address - Street 1:7225 LONDON BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-1182
Practice Address - Country:US
Practice Address - Phone:702-466-6137
Practice Address - Fax:702-586-6645
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst