MEDICARE: LESLIE Y PADILLA

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	RBT-23-288078	CO

General Provider Information

NPI Number	:	1447020458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLIE Y PADILLA

Provider Business Mailing Address
First Line	:	4243 GUNBARREL DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80925-1000
Country	:	US
Telephone Number	:	719-298-0099
Fax Number	:

Provider Business Practice Location Address
First Line	:	3595 E FOUNTAIN BLVD STE 145
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-1791
Country	:	US
Telephone Number	:	254-630-1578
Fax Number	:

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

Provider Enumeration Date	:	01/02/2024
Last Update Date	:	01/04/2024

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Directions to “ LESLIE Y PADILLA ” Practice Location

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