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NPI Code Detail

MEDICARE: JENNIFER HALEY

MEDICARE: JENNIFER HALEY
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1841682192
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER HALEY
Provider Business Mailing Address
First Line : 7189 S DURANGO DR
Second Line : #110
City : LAS VEGAS
State : NV
Zip : 89113-2019
Country : US
Telephone Number : 702-273-6973
Fax Number :
Provider Business Practice Location Address
First Line : 6330 MCLEOD DR
Second Line : STE. 3
City : LAS VEGAS
State : NV
Zip : 89120-4430
Country : US
Telephone Number : 702-754-3484
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2015
Last Update Date : 02/24/2015

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