MEDICARE: LEILA DIANE KOEHLER

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1851250856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEILA DIANE KOEHLER

Provider Business Mailing Address
First Line	:	520 MAIN ST APT 2
Second Line	:
City	:	WINONA
State	:	MN
Zip	:	55987-3226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3936 CIRCLE DR
Second Line	:
City	:	HOLMEN
State	:	WI
Zip	:	54636-9187
Country	:	US
Telephone Number	:	608-394-6930
Fax Number	:

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “ LEILA DIANE KOEHLER ” Practice Location

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