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NPI Code Detail

MEDICARE: LEIAH ELIZABETH ANDRES MS, BCBA

MEDICARE: LEIAH ELIZABETH ANDRES MS, 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 AnalystWA

General Provider Information

NPI Number : 1699537456
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEIAH ELIZABETH ANDRES MS, BCBA
Provider Business Mailing Address
First Line : 3111 BROAD ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-8342
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3111 BROAD ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98225-8342
Country : US
Telephone Number : 714-732-0770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2024
Last Update Date : 01/30/2024

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