Provider Demographics
NPI:1821596933
Name:GIORVAS, HAILEY (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:GIORVAS
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:
Other - Last Name:HASBROOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5500 NE 109TH CT STE A
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6104
Mailing Address - Country:US
Mailing Address - Phone:971-319-5932
Mailing Address - Fax:
Practice Address - Street 1:5500 NE 109TH CT STE A
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6104
Practice Address - Country:US
Practice Address - Phone:971-319-5932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-24
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1-21-55202103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst