Healthcare Provider Details

I. General information

NPI: 1215786116
Provider Name (Legal Business Name): LEAH N BLOWERS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MAIN ST S
MINOT ND
58701-3914
US

IV. Provider business mailing address

100 MAIN ST S
MINOT ND
58701-3914
US

V. Phone/Fax

Practice location:
  • Phone: 701-389-9363
  • Fax:
Mailing address:
  • Phone: 701-389-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberL167
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: