Provider Demographics
NPI:1639428212
Name:HAYDEN, LAURA THIBODEAUX (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:THIBODEAUX
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COOPER DR STE 110
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-3996
Mailing Address - Country:US
Mailing Address - Phone:469-851-2200
Mailing Address - Fax:
Practice Address - Street 1:600 COOPER DR STE 110
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-3996
Practice Address - Country:US
Practice Address - Phone:469-851-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-21-164822106S00000X
TX6735103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician