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NPI 1083576870

NPI 1083576870 : LEILAH JADE GARCIA : KISSIMMEE, FL

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General NPI Number Information
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    NPI Number           |    1083576870
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    Entity Type          |    Individual 
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    Provider Name        |    LEILAH JADE GARCIA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/01/2025
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    Last Update Date     |    12/01/2025
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Provider Practice Location Address
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    Address Line         |    810 N JOHN YOUNG PKWY 
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    City                 |    KISSIMMEE
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    State                |    FL
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    Zip                  |    34741-4912
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    Country              |    US
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    Telephone            |    407-501-7960
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    300 INTERNATIONAL PKWY STE 200 
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    City                 |    LAKE MARY
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    State                |    FL
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    Zip                  |    32746-5028
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    Country              |    US
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    Telephone            |    866-610-0580
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    Fax                  |    866-611-1558
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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