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General NPI Number Information
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NPI Number | 1962908269
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Entity Type | Individual
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Provider Name | HALEY PEJOVICH M.A., BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 4917 GOLDEN TRIANGLE BLVD UNIT 421
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City | FORT WORTH
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State | TX
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Zip | 76244-4480
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Country | US
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Telephone | 817-734-6515
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Fax |
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Provider Business Mailing Address
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Address Line | 4917 GOLDEN TRIANGLE BLVD UNIT 421
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City | FORT WORTH
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State | TX
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Zip | 76244-4480
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Country | US
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Telephone | 817-734-6515
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 8903
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License Number State | SC
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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 | RBT-17-37249
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License Number State | TX
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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 |
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License Number State | TX
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