Provider Demographics
NPI:1831408301
Name:HAINLINE, DARLEEN ANN (BCBA)
Entity type:Individual
Prefix:
First Name:DARLEEN
Middle Name:ANN
Last Name:HAINLINE
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 1:104 S. MCKINLEY SUITE E
Mailing Address - Street 2:DSFC
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084
Mailing Address - Country:US
Mailing Address - Phone:636-583-5801
Mailing Address - Fax:636-583-5597
Practice Address - Street 1:104 S MCKINLEY AVE
Practice Address - Street 2:SUITE E
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-1800
Practice Address - Country:US
Practice Address - Phone:636-583-5801
Practice Address - Fax:636-583-5597
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-5074103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst