Provider Demographics
NPI:1053011569
Name:HAYNES, JENE'A DAJOUN
Entity type:Individual
Prefix:
First Name:JENE'A
Middle Name:DAJOUN
Last Name:HAYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E DAVIS ST STE 134
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4588
Mailing Address - Country:US
Mailing Address - Phone:972-632-7015
Mailing Address - Fax:844-402-0972
Practice Address - Street 1:300 E DAVIS ST STE 134
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-4588
Practice Address - Country:US
Practice Address - Phone:972-632-7015
Practice Address - Fax:844-402-0972
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68699104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker