Provider Demographics
NPI:1891540902
Name:LEONARD, NIESHA (BCBA, LBA-NY)
Entity type:Individual
Prefix:
First Name:NIESHA
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:BCBA, LBA-NY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 LELAND AVE APT 2R
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-3917
Mailing Address - Country:US
Mailing Address - Phone:917-941-2499
Mailing Address - Fax:
Practice Address - Street 1:1421 LELAND AVE APT 2R
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-3917
Practice Address - Country:US
Practice Address - Phone:917-941-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003415-01103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst