Provider Demographics
NPI:1497253025
Name:HAYES, ANDREA JEANNETTE (BCBA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:JEANNETTE
Last Name:HAYES
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 1:2252 LONGSPUR LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3912
Mailing Address - Country:US
Mailing Address - Phone:626-622-7291
Mailing Address - Fax:
Practice Address - Street 1:2252 LONGSPUR LN
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3912
Practice Address - Country:US
Practice Address - Phone:626-622-7291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator