Healthcare Provider Details

I. General information

NPI: 1912779489
Provider Name (Legal Business Name): LIA KAISER BCBA/COBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2023
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3521 BRIARFIELD BLVD
MAUMEE OH
43537-9387
US

IV. Provider business mailing address

2222 CHERRY ST
TOLEDO OH
43608-2673
US

V. Phone/Fax

Practice location:
  • Phone: 419-794-7259
  • Fax: 419-794-7261
Mailing address:
  • Phone: 419-251-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCOBA.01464
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: