Provider Demographics
NPI:1073317749
Name:HAYNES, RHIANNON
Entity type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:HAYNES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 FARMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-9386
Mailing Address - Country:US
Mailing Address - Phone:260-273-5311
Mailing Address - Fax:765-378-9019
Practice Address - Street 1:1025 FARMINGTON DR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-9386
Practice Address - Country:US
Practice Address - Phone:260-273-5311
Practice Address - Fax:765-378-9019
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001392A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant