Healthcare Provider Details

I. General information

NPI: 1124675798
Provider Name (Legal Business Name): HANNAH ELISE EFAW M.S., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HANNAH ELISE EFAW COLEMAN M.S., BCBA

II. Dates (important events)

Enumeration Date: 08/19/2019
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 OSPREY LN
LUTZ FL
33549-9374
US

IV. Provider business mailing address

6012 PRINTERY ST UNIT 107
TAMPA FL
33616-1410
US

V. Phone/Fax

Practice location:
  • Phone: 813-768-0711
  • Fax: 813-696-0707
Mailing address:
  • Phone: 813-297-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-52210
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: