Provider Demographics
NPI:1427174366
Name:WALTERS, LEANN MARIE (MS ED, BCABA)
Entity type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:MARIE
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MS ED, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8416 W 69TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-1219
Mailing Address - Country:US
Mailing Address - Phone:913-677-0799
Mailing Address - Fax:
Practice Address - Street 1:8416 W 69TH TER
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-1219
Practice Address - Country:US
Practice Address - Phone:913-677-0799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health