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NPI Code Detail

MEDICARE: HAILEY J BOHL

MEDICARE: HAILEY J BOHL
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
1106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1720916935
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAILEY J BOHL
Provider Business Mailing Address
First Line : 1704 SW 13TH CT
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33312-4150
Country : US
Telephone Number : 954-651-0816
Fax Number :
Provider Business Practice Location Address
First Line : 1000 NW 65TH ST STE 201
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-1113
Country : US
Telephone Number : 954-271-2323
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “ HAILEY J BOHL ” Practice Location

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