Provider Demographics
NPI:1942447040
Name:HAINES, NOREEN MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:NOREEN
Middle Name:MARIE
Last Name:HAINES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:NOREEN
Other - Middle Name:MARIE
Other - Last Name:HAINES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:697 103RD AVE N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-3220
Mailing Address - Country:US
Mailing Address - Phone:239-919-0266
Mailing Address - Fax:
Practice Address - Street 1:697 103RD AVE N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-3220
Practice Address - Country:US
Practice Address - Phone:239-919-0266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 0014760175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO065457OtherID #
FLMA0014760OtherFLORIDA LICENSE #