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General NPI Number Information
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NPI Number | 1831446509
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Entity Type | Individual
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Provider Name | REBA HALEY PHD,CAP, RMFT
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Gender | Female
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Dates
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Enumeration Date | 08/12/2012
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 212 S SAINT CLOUD AVE BLDG A
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City | VALRICO
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State | FL
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Zip | 33594-3992
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Country | US
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Telephone | 813-716-3996
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Fax | 813-820-3793
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Provider Business Mailing Address
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Address Line | PO BOX 648
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City | VALRICO
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State | FL
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Zip | 33595-0648
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MH1822
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License Number State | FL
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