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NPI Code Detail

MEDICARE: ALESIA LESHA ANDERSON

MEDICARE: ALESIA LESHA ANDERSON
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
1106S00000XBehavior TechnicianTX

General Provider Information

NPI Number : 1043140254
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALESIA LESHA ANDERSON
Provider Business Mailing Address
First Line : 701 GLENCREST LN STE A
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5145
Country : US
Telephone Number : 903-686-9941
Fax Number :
Provider Business Practice Location Address
First Line : 701 GLENCREST LN STE A
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-5145
Country : US
Telephone Number : 903-686-9941
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2026
Last Update Date : 05/20/2026

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Directions to “ ALESIA LESHA ANDERSON ” Practice Location

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