Provider Demographics
NPI:1649792391
Name:HARRIS-BROWN, HALEY ELTON (M,ED, BCBA)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:ELTON
Last Name:HARRIS-BROWN
Suffix:
Gender:F
Credentials:M,ED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8405
Mailing Address - Country:US
Mailing Address - Phone:678-648-7644
Mailing Address - Fax:
Practice Address - Street 1:6505 SHILOH RD STE 100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:678-648-7644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-17-26756103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst