MEDICARE: SARA LEYERLE

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	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1083297451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA LEYERLE

Provider Business Mailing Address
First Line	:	905 ROBERTS CUT OFF RD
Second Line	:
City	:	RIVER OAKS
State	:	TX
Zip	:	76114-2825
Country	:	US
Telephone Number	:	817-731-2293
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 ROBERTS CUT OFF RD
Second Line	:
City	:	RIVER OAKS
State	:	TX
Zip	:	76114-2825
Country	:	US
Telephone Number	:	817-731-2293
Fax Number	:

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

Provider Enumeration Date	:	05/03/2021
Last Update Date	:	05/27/2021

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Directions to “ SARA LEYERLE ” Practice Location

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