Provider Demographics
NPI:1386205060
Name:FRIEND, HAYLEY ALEXANDRA (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:HAYLEY
Middle Name:ALEXANDRA
Last Name:FRIEND
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 RIVER PARK DR APT 831A
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-0709
Mailing Address - Country:US
Mailing Address - Phone:210-725-0233
Mailing Address - Fax:
Practice Address - Street 1:3450 RIVER PARK DR APT 831A
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-0709
Practice Address - Country:US
Practice Address - Phone:210-725-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst