Healthcare Provider Details

I. General information

NPI: 1497689590
Provider Name (Legal Business Name): LEILA LANSBERRY RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 S DAVIS AVE
ELKINS WV
26241-3529
US

IV. Provider business mailing address

283 POINT MOUNTAIN RD
VALLEY HEAD WV
26294-7000
US

V. Phone/Fax

Practice location:
  • Phone: 304-801-3258
  • Fax:
Mailing address:
  • Phone: 304-931-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB1210365
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: