MEDICARE: LESLIE PAIGE HANY M.S., BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1245473644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE PAIGE HANY M.S., BCBA

Provider Business Mailing Address
First Line	:	7595 BAYMEADOWS CIR W
Second Line	:	APT 2405
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-1879
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7595 BAYMEADOWS CIR W
Second Line	:	APT 2405
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-1879
Country	:	US
Telephone Number	:	813-449-0688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	04/14/2009

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