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NPI Code Detail

MEDICARE: LUNA LIZETH BARRERAS-LEON

MEDICARE:   LUNA LIZETH BARRERAS-LEON
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 Technician

General Provider Information

NPI Number : 1679419584
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUNA LIZETH BARRERAS-LEON
Provider Business Mailing Address
First Line : 1827 E IRELAND RD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46614-2845
Country : US
Telephone Number : 574-387-4313
Fax Number :
Provider Business Practice Location Address
First Line : 1511 29TH AVENUE DR NE
Second Line :
City : HICKORY
State : NC
Zip : 28601-7324
Country : US
Telephone Number : 574-387-4313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2026
Last Update Date : 04/24/2026

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Directions to “ LUNA LIZETH BARRERAS-LEON ” Practice Location

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