MEDICARE: LEAH EDWARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1033099155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH EDWARDS

Provider Business Mailing Address
First Line	:	9238 PEMBROOK FALLS AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4927
Country	:	US
Telephone Number	:	702-706-7635
Fax Number	:

Provider Business Practice Location Address
First Line	:	3140 S RAINBOW BLVD STE 400
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6234
Country	:	US
Telephone Number	:	702-706-7635
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/08/2025
Last Update Date	:	10/24/2025

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Directions to “ LEAH EDWARDS ” Practice Location

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