Provider Demographics
NPI:1982732418
Name:HAFFNER-SZYNSKIE, MISTY (OTR)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:HAFFNER-SZYNSKIE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1981 215TH ST
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-4549
Mailing Address - Country:US
Mailing Address - Phone:712-542-0123
Mailing Address - Fax:712-246-2594
Practice Address - Street 1:201 N 7TH ST
Practice Address - Street 2:
Practice Address - City:CLARINDA
Practice Address - State:IA
Practice Address - Zip Code:51632-6400
Practice Address - Country:US
Practice Address - Phone:712-542-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1159225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI14959Medicare ID - Type UnspecifiedIOWA MEDICARE NUMBER