Provider Demographics
NPI:1396312583
Name:LEONARD, KATELYN ELIZABETH (BCBA)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ELIZABETH
Last Name:LEONARD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 S MARTIN LUTHER KING JR AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-5600
Mailing Address - Country:US
Mailing Address - Phone:704-638-9020
Mailing Address - Fax:
Practice Address - Street 1:1775 S MARTIN LUTHER KING JR AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-5600
Practice Address - Country:US
Practice Address - Phone:704-638-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-24-70986103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst