Provider Demographics
NPI:1417242934
Name:HAFF, MARYA (BCBA)
Entity Type:Individual
Prefix:
First Name:MARYA
Middle Name:
Last Name:HAFF
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 1:2171 CAMPUS DR
Mailing Address - Street 2:# 260
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-1422
Mailing Address - Country:US
Mailing Address - Phone:877-285-6430
Mailing Address - Fax:877-285-6431
Practice Address - Street 1:2171 CAMPUS DR
Practice Address - Street 2:# 260
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-1422
Practice Address - Country:US
Practice Address - Phone:877-285-6430
Practice Address - Fax:877-285-6431
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-5226103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst