Individual
STACEE LEATHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
9902 SWANSON BLVD, CLIVE, IA 50325-6932
(847) 322-9377
Mailing address
1805 36TH ST, MOLINE, IL 61265-3449
(309) 798-1780
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/19/2020
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