Provider Demographics
NPI:1821315532
Name:HAYNES, DONNA KAY (BA; BHRS)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:KAY
Last Name:HAYNES
Suffix:
Gender:F
Credentials:BA; BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5363
Mailing Address - Country:US
Mailing Address - Phone:918-470-4280
Mailing Address - Fax:580-371-2056
Practice Address - Street 1:111 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5363
Practice Address - Country:US
Practice Address - Phone:918-470-4280
Practice Address - Fax:580-371-2056
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation