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NPI Code Detail

MEDICARE: LEENA GEORGE

MEDICARE:   LEENA  GEORGE
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 : 1891260063
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEENA GEORGE
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 950 E STATE HIGHWAY 114 STE 160
Second Line :
City : SOUTHLAKE
State : TX
Zip : 76092-5261
Country : US
Telephone Number : 818-345-2345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2018
Last Update Date : 10/03/2018

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Directions to “ LEENA GEORGE ” Practice Location

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