Provider Demographics
NPI:1194290213
Name:HAINES, SARAH (RBT)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:HAINES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 W 23RD ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-2391
Mailing Address - Country:US
Mailing Address - Phone:850-481-1448
Mailing Address - Fax:
Practice Address - Street 1:2611 W 23RD ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-2391
Practice Address - Country:US
Practice Address - Phone:850-481-1448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician