Provider Demographics
NPI:1669913356
Name:HAYES, ELISABETH (BCBA)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:HAYES
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 1:936 SW 1ST AVE # 433
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-4520
Mailing Address - Country:US
Mailing Address - Phone:805-252-7770
Mailing Address - Fax:
Practice Address - Street 1:936 SW 1ST AVE # 433
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130
Practice Address - Country:US
Practice Address - Phone:805-252-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11314130103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst