Provider Demographics
NPI:1629586342
Name:YAKAVONIS, HAILEY MAY (BCBA)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:MAY
Last Name:YAKAVONIS
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 1:105 HMS STAYNER DR
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1664
Mailing Address - Country:US
Mailing Address - Phone:617-957-6451
Mailing Address - Fax:
Practice Address - Street 1:105 HMS STAYNER DR
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1664
Practice Address - Country:US
Practice Address - Phone:617-957-6451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3955103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst