ANTHONY HAYNES

ROSEBURG, OR
NPI1972053205
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  13-12-59)
Enumeration Date2016-10-11
Last Update Date2016-10-11
Business Address
-- ANTHONY HAYNES
2575 NW KLINE ST
ROSEBURG, OR 97471-8827
Phone number: 541-673-3504
Mailing Address
-- ANTHONY HAYNES
2575 NW KLINE ST
ROSEBURG, OR 97471-8827
Phone number: 541-673-3504