Provider Demographics
NPI:1659680528
Name:HASKINS, BRANDON JAMES
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:JAMES
Last Name:HASKINS
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 1:701 INDIAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7480
Mailing Address - Country:US
Mailing Address - Phone:907-747-3636
Mailing Address - Fax:907-747-5316
Practice Address - Street 1:701 INDIAN RIVER RD
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7480
Practice Address - Country:US
Practice Address - Phone:907-747-3636
Practice Address - Fax:907-747-5316
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst