Basic Information
| Provider Information | |||||||||
| NPI: | 1821694779 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCKEE | ||||||||
| FirstName: | HALEY | ||||||||
| MiddleName: | ELISABETH | ||||||||
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| Credential: | RBT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2478 LONG SANDY CIR | ||||||||
| Address2: | |||||||||
| City: | MERRITT ISLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329524168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3214275823 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 SOLUTIONS WAY | ||||||||
| Address2: | |||||||||
| City: | ROCKLEDGE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329553620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3216399800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2020 | ||||||||
| LastUpdateDate: | 12/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.