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General NPI Number Information
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NPI Number | 1487392155
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Entity Type | Individual
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Provider Name | HAYLEY LECKNER MA, BCBA
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Gender | Female
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 05/23/2022
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Provider Practice Location Address
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Address Line | 8438 INDIANA ST
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6357
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Country | US
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Telephone | 219-525-4572
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Fax |
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Provider Business Mailing Address
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Address Line | 12941 W 151ST AVE
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City | CEDAR LAKE
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State | IN
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Zip | 46303-9045
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Country | US
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Telephone | 219-741-6239
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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 | 1-21-51631
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License Number State | IN
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