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General NPI Number Information
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NPI Number | 1063033652
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Entity Type | Individual
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Provider Name | LEANNA MONIQUE GONZALEZ BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 29077 CLEMENS RD
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City | WESTLAKE
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State | OH
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Zip | 44145-1135
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Country | US
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Telephone | 440-871-6568
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Fax | 317-520-8200
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Provider Business Mailing Address
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Address Line | 3500 DEPAUW BLVD STE 3070
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-6135
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | COBA.342
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-16-23074
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License Number State | OH
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