Healthcare Provider Details

I. General information

NPI: 1346164019
Provider Name (Legal Business Name): KATHERINE LEISTER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8316 HIXSON SPRINGS RD
SIGNAL MOUNTAIN TN
37377-1714
US

IV. Provider business mailing address

8316 HIXSON SPRINGS RD
SIGNAL MOUNTAIN TN
37377-1714
US

V. Phone/Fax

Practice location:
  • Phone: 904-509-7007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-53995
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: