Most Relevant Information
Provider Data
| NPI Number: | 1003047440 |
| Provider Name: | TONI FAYE HAITHCOCK RD |
| Entity Type: | Individual |
| Taxonomy Code: | 133V00000X |
| Specialty: | Dietitian, Registered |
| License Number: | 812626 |
Most Important Dates
| Enumeration Date: | 08/03/2009 |
| Last Updated: | 04/30/2015 |
Provider Practice Location
1615 E 13 MILE RD APT 205
MADISON HEIGHTS
MI
480715020
Practice Location Phone/Fax
| Phone: | 5866046585 |
| Fax: |
Provider Mailing Location
PO BOX 71732
MADISON HEIGHTS
MI
480710732
Provider Mailing Phone/Fax
| Phone: | 5866046585 |
| Fax: |