Provider Demographics
NPI:1699378588
Name:CHRISTENSEN, HALEY (BCBA)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:
Last Name:CHRISTENSEN
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 1:5678 SINGLETREE DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8632
Mailing Address - Country:US
Mailing Address - Phone:301-606-8299
Mailing Address - Fax:
Practice Address - Street 1:8615 E VILLAGE AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886-4316
Practice Address - Country:US
Practice Address - Phone:240-912-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherN/A