Basic Information
| Provider Information | |||||||||
| NPI: | 1043265366 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAYNES | ||||||||
| FirstName: | TINA | ||||||||
| MiddleName: | G. | ||||||||
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| Credential: | MT-BC, LCAT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3647 DIXIE LN | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371293103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158931360 | ||||||||
| FaxNumber: | 6158676162 | ||||||||
| Practice Location | |||||||||
| Address1: | 3400 LEBANON RD | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | TN | ||||||||
| PostalCode: | 371291237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158931360 | ||||||||
| FaxNumber: | 6158676162 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225A00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Music Therapist |
No ID Information.