Leslie Praetorius, BCBA, LBA
Individual provider Active NPI Behavior Analyst · Forest, LA
NPI 1316365851 · NPPES record last updated Aug 19, 2014
Key facts
- NPI
- 1316365851
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 11415112 (LA)
- Practice address
- 125 Walnut St
Forest, LA 71242 - Phone
- (504) 460-5142
- NPI assigned
- Apr 2, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11415112 | LA | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11415112 | LA | Yes |
Addresses
Primary practice location
125 Walnut St
Forest, LA 71242
Mailing address
PO Box 230
Forest, LA 71242-0230
Phone (504) 460-5142
Other providers in Forest, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.