Provider Demographics
NPI:1225681950
Name:HALEY, DEBORAH JUNE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JUNE
Last Name:HALEY
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 E. PARHAM ROAD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228
Mailing Address - Country:US
Mailing Address - Phone:804-365-2047
Mailing Address - Fax:804-716-7186
Practice Address - Street 1:1640 E. PARHAM ROAD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228
Practice Address - Country:US
Practice Address - Phone:804-365-2047
Practice Address - Fax:804-716-7186
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001435103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst