Provider Demographics
NPI:1689901605
Name:HAYMAN, MARILEE STAFFORD (BCBA)
Entity Type:Individual
Prefix:MS
First Name:MARILEE
Middle Name:STAFFORD
Last Name:HAYMAN
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 1:3062 TERN WAY
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-4555
Mailing Address - Country:US
Mailing Address - Phone:727-455-3923
Mailing Address - Fax:727-572-8265
Practice Address - Street 1:3062 TERN WAY
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-4555
Practice Address - Country:US
Practice Address - Phone:727-455-3923
Practice Address - Fax:727-572-8265
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst