Individual
CALLAN LEE HAZELBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., BCBA
Contact information
Practice address
4710 BENNINGTON PL, NORTH CHARLESTON, SC 29420-7209
(843) 338-3769
Mailing address
4710 BENNINGTON PLACE, NORTH CHARLESTON, SC 29420
(843) 338-3769
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/04/2013
Last updated
06/26/2014
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