Provider Demographics
NPI:1609265800
Name:GARR, HAYLEY MICHELLE (MS BCBA)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:MICHELLE
Last Name:GARR
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 HAMPSHIRE ST
Mailing Address - Street 2:APT 4
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3450
Mailing Address - Country:US
Mailing Address - Phone:805-603-3441
Mailing Address - Fax:
Practice Address - Street 1:1090 HAMPSHIRE ST
Practice Address - Street 2:APT 4
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3450
Practice Address - Country:US
Practice Address - Phone:805-603-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-14-17781103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-14-17781OtherBACB