Provider Demographics
NPI:1497093496
Name:HAYS, TABITHA NICOLE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:TABITHA
Middle Name:NICOLE
Last Name:HAYS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:57 HADDONFIELD RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-4813
Mailing Address - Country:US
Mailing Address - Phone:856-616-9442
Mailing Address - Fax:856-667-3563
Practice Address - Street 1:7350 SNOWBIRD WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46259-1738
Practice Address - Country:US
Practice Address - Phone:317-430-9917
Practice Address - Fax:856-667-3563
Is Sole Proprietor?:No
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-12115103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst