Individual
AMY LESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18111 NW 68TH AVE APT G102, HIALEAH, FL 33015-3987
(551) 697-4711
Mailing address
18111 NW 68TH AVE APT G102, HIALEAH, FL 33015-3987
(551) 697-4711
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20-127430
FL
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107399000
—
FL
Enumeration date
05/18/2021
Last updated
12/03/2024
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