Provider Demographics
NPI:1336663954
Name:NANI, HALLEY RAFFERTY (BCBA)
Entity Type:Individual
Prefix:
First Name:HALLEY
Middle Name:RAFFERTY
Last Name:NANI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11820 CYPRESS CORNER LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-1132
Mailing Address - Country:US
Mailing Address - Phone:281-894-1423
Mailing Address - Fax:832-912-4475
Practice Address - Street 1:14110 CYPRESS CREEK BLVD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3214
Practice Address - Country:US
Practice Address - Phone:281-894-1423
Practice Address - Fax:832-912-4475
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-17-25936103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst