Provider Demographics
NPI:1124675798
Name:EFAW, HANNAH ELISE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELISE
Last Name:EFAW
Suffix:
Gender:
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:ELISE EFAW
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:6012 PRINTERY ST UNIT 107
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33616-1410
Mailing Address - Country:US
Mailing Address - Phone:813-297-3033
Mailing Address - Fax:
Practice Address - Street 1:2009 OSPREY LN
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-9374
Practice Address - Country:US
Practice Address - Phone:813-768-0711
Practice Address - Fax:813-696-0707
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-52210103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst