Individual
LEICA M ANZALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA, BCBA
Contact information
Practice address
421 FAYETTEVILLE ST STE 1100, RALEIGH, NC 27601-3000
(977) 418-2978
(866) 500-2186
Mailing address
350 FAIRWAY DR STE 101, DEERFIELD BCH, FL 33441-1834
(977) 418-2978
(866) 500-2186
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
271
NC
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
720282G
—
NC
Enumeration date
09/15/2014
Last updated
09/17/2024
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