Healthcare Provider Details

I. General information

NPI: 1629650882
Provider Name (Legal Business Name): HAILEE JEAN SZROMBA MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2021
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 N GILBERT RD STE 101
GILBERT AZ
85234-3481
US

IV. Provider business mailing address

7139 LAVERNE LN APT 3E
TINLEY PARK IL
60477-4972
US

V. Phone/Fax

Practice location:
  • Phone: 480-559-8089
  • Fax: 317-520-8200
Mailing address:
  • Phone: 708-307-9549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number152.003116
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: