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General NPI Number Information
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NPI Number | 1194333153
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Entity Type | Organization
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Legal Business Name | LEAP BEHAVIOR ANALYSIS, LLC
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Dates
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Enumeration Date | 07/16/2020
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Last Update Date | 07/16/2020
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Provider Practice Location Address
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Address Line | 1680 S JEFFERSON AVE STE G
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City | COOKEVILLE
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State | TN
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Zip | 38506-2527
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Country | US
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Telephone | 931-288-2422
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Fax |
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Provider Business Mailing Address
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Address Line | 1680D S JEFFERSON AVE STE G
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City | COOKEVILLE
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State | TN
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Zip | 38506-5578
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Country | US
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Telephone | 931-288-2422
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Fax |
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Authorized Official
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Title or Position | BCBA
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Name | ALLISON OLMSTEAD
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Credential |
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Telephone | 931-288-2422
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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 |
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License Number State |
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