Provider Demographics
NPI:1477334175
Name:JENSEN, HAILEY MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:MARIE
Last Name:JENSEN
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 1:888 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-6148
Mailing Address - Country:US
Mailing Address - Phone:206-999-9747
Mailing Address - Fax:360-879-5108
Practice Address - Street 1:13709 TWIN LAKES DR E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-7574
Practice Address - Country:US
Practice Address - Phone:206-999-9747
Practice Address - Fax:360-879-5108
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst