Healthcare Provider Details

I. General information

NPI: 1982112405
Provider Name (Legal Business Name): HEATHER LEE ANGLISS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. HEATHER LEE MEGNIA

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 01/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ADOLFSECKER WEG 11B
BAD SCHWALBACH HESSEN
65307
DE

IV. Provider business mailing address

ADOLFSECKER WEG 11B
BAD SCHWALBACH HESSEN
65307
DE

V. Phone/Fax

Practice location:
  • Phone: 17-532-7447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-16-22936
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: