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NPI Code Detail

MEDICARE: IRENE LEYRER BCBA

MEDICARE: IRENE LEYRER BCBA
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
1103K00000XBehavior Analyst7401003006MI

General Provider Information

NPI Number : 1629736970
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRENE LEYRER BCBA
Provider Business Mailing Address
First Line : 1324 MONTGOMERY AVE
Second Line :
City : MUSKEGON
State : MI
Zip : 49441-1721
Country : US
Telephone Number : 231-571-8201
Fax Number :
Provider Business Practice Location Address
First Line : 23800 NORTHWESTERN HWY STE 190L
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-7740
Country : US
Telephone Number : 734-985-2964
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2021
Last Update Date : 09/11/2025

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