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General NPI Number Information
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NPI Number | 1801302039
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Entity Type | Individual
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Provider Name | HEATHER HANIFIN
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Gender | Female
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 125 HALF MILE ROAD SUITE 200
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City | RED BANK
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State | NJ
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Zip | 07701-6749
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Country | US
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Telephone | 855-832-6727
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Fax |
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Provider Business Mailing Address
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Address Line | 5947B GANNET AVE
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City | EWA BEACH
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State | HI
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Zip | 96706-3256
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Country | US
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Telephone |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB388215
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-22-57625
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License Number State |
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