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NPI Code Detail

MEDICARE: LENNON A COFFMAN BCABA

MEDICARE: LENNON A COFFMAN BCABA
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
1106S00000XBehavior Technician
2106E00000XAssistant Behavior Analyst0-25-15973CA

General Provider Information

NPI Number : 1255997938
Entity Type Code : Individual
Provider Name (Legal Business Name) : LENNON A COFFMAN BCABA
Provider Business Mailing Address
First Line : 3995 MARCOLA RD
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-7948
Country : US
Telephone Number : 541-726-1465
Fax Number :
Provider Business Practice Location Address
First Line : 2721 CESAR CHAVEZ BLVD
Second Line :
City : FRESNO
State : CA
Zip : 93721-2366
Country : US
Telephone Number : 559-477-5546
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2019
Last Update Date : 05/23/2025

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Directions to “ LENNON A COFFMAN BCABA” Practice Location

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