MEDICARE: LE'ANN L MILINDER BCBA

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	1-12-12027	NH

General Provider Information

NPI Number	:	1437495678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LE'ANN L MILINDER BCBA

Provider Business Mailing Address
First Line	:	22 BAYVIEW DR
Second Line	:
City	:	STOCKTON SPRINGS
State	:	ME
Zip	:	04981-4637
Country	:	US
Telephone Number	:	603-513-1526
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 BAYVIEW DR
Second Line	:
City	:	STOCKTON SPRINGS
State	:	ME
Zip	:	04981-4637
Country	:	US
Telephone Number	:	603-513-1526
Fax Number	:

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

Provider Enumeration Date	:	12/17/2012
Last Update Date	:	05/24/2022

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