Most Relevant Information
Provider Data
| NPI Number: | 1003446493 |
| Provider Name: | HALEY JOHNSON RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/24/2020 |
| Last Updated: | 01/24/2020 |
Provider Practice Location
355 QUARTERMASTER CT
JEFFERSONVILLE
IN
471303670
Practice Location Phone/Fax
| Phone: | 8152589802 |
| Fax: |
Provider Mailing Location
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS
IN
462686135
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |