MEDICARE: LEYLA YVONNE JOWHARI M.S.,BCBA,LBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-25-80181	TX

General Provider Information

NPI Number	:	1154996742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEYLA YVONNE JOWHARI M.S.,BCBA,LBA

Provider Business Mailing Address
First Line	:	6914 BRISBANE CT STE 200
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-4924
Country	:	US
Telephone Number	:	505-456-6474
Fax Number	:

Provider Business Practice Location Address
First Line	:	8540 BROADWAY ST STE 102
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7710
Country	:	US
Telephone Number	:	505-456-6474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	04/02/2025

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