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General NPI Number Information
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NPI Number | 1730654682
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Entity Type | Individual
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Provider Name | LEAH LIAKOS BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 830 PARKER SQ
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City | FLOWER MOUND
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State | TX
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Zip | 75028-7429
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Country | US
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Telephone | 972-410-5297
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Fax |
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Provider Business Mailing Address
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Address Line | 650 CHURCH ST # 215
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City | PLYMOUTH
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State | MI
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Zip | 48170-1689
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Country | US
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Telephone | 972-410-5297
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-20-46119
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License Number State | MI
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