Healthcare Provider Details

I. General information

NPI: 1497185755
Provider Name (Legal Business Name): HADISHA DANIEL BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2013
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 BRIDFORD PKWY APT 1F
GREENSBORO NC
27409-3504
US

IV. Provider business mailing address

930 BRIDFORD PKWY APT 1F
GREENSBORO NC
27409-3504
US

V. Phone/Fax

Practice location:
  • Phone: 305-340-2951
  • Fax: 305-330-5532
Mailing address:
  • Phone: 305-340-2951
  • Fax: 305-330-5532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number12150958
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: