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General NPI Number Information
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NPI Number | 1366172884
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Entity Type | Individual
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Provider Name | HAILEY EASTEP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 900 NW EASTMAN PKWY STE 38
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City | GRESHAM
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State | OR
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Zip | 97030-5533
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Country | US
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Telephone | 248-436-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 27777 INKSTER RD STE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-5312
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Country | US
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Telephone | 248-436-4400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-24-15408
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-82349
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License Number State | OR
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