Basic Information
| Provider Information | |||||||||
| NPI: | 1598203010 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUNYONS-HIERS | ||||||||
| FirstName: | JAMIE | ||||||||
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| Credential: | ED.S. NCSP, BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 175 MIDDLE ST | ||||||||
| Address2: | SUITE 1201 | ||||||||
| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327463625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8666100580 | ||||||||
| FaxNumber: | 8666100580 | ||||||||
| Practice Location | |||||||||
| Address1: | 1015 NW 56TH TER | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326054481 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3528355520 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2017 | ||||||||
| LastUpdateDate: | 02/03/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-16-22686 | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst | 103TS0200X | SS1278 | FL | N | Behavioral Health & Social Service Providers | Psychologist | School |
No ID Information.