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NPI Code Detail

MEDICARE: MS. LEILA BRUCE HARALSON-COLES BCBA

MEDICARE: MS. LEILA BRUCE HARALSON-COLES 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
1103K00000XBehavior Analyst11622543TX

General Provider Information

NPI Number : 1629420252
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LEILA BRUCE HARALSON-COLES BCBA
Provider Business Mailing Address
First Line : 16782 VON KARMAN AVE STE 11
Second Line :
City : IRVINE
State : CA
Zip : 92606-2417
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Provider Business Practice Location Address
First Line : 2717 COMMERCIAL CENTER BLVD STE E200
Second Line :
City : KATY
State : TX
Zip : 77494-7823
Country : US
Telephone Number : 855-223-7123
Fax Number : 619-374-7134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2016
Last Update Date : 12/19/2022

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