Provider Demographics
NPI:1427538909
Name:HAINES, HALEY SABRINA (BCBA)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:SABRINA
Last Name:HAINES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16103 PENN STATE RD
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34614-1015
Mailing Address - Country:US
Mailing Address - Phone:352-232-9959
Mailing Address - Fax:
Practice Address - Street 1:2210 CR 528
Practice Address - Street 2:
Practice Address - City:SUMTERVILLE
Practice Address - State:FL
Practice Address - Zip Code:33585-5214
Practice Address - Country:US
Practice Address - Phone:352-569-4252
Practice Address - Fax:352-314-2909
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-22-58586103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017486800Medicaid