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NPI Code Detail

MEDICARE: LESLIE SCOBIE LLMSW, BCBA, LBA

MEDICARE: LESLIE SCOBIE LLMSW, 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
1103K00000XBehavior Analyst1-15-19073

General Provider Information

NPI Number : 1891171898
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE SCOBIE LLMSW, BCBA, LBA
Provider Business Mailing Address
First Line : PO BOX 663
Second Line :
City : LAKELAND
State : MI
Zip : 48143-0663
Country : US
Telephone Number : 810-599-2129
Fax Number :
Provider Business Practice Location Address
First Line : 4000 W MICHIGAN AVE
Second Line :
City : LANSING
State : MI
Zip : 48917-2856
Country : US
Telephone Number : 517-258-0052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2015
Last Update Date : 09/21/2021

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