Individual
SAMANTHA LEITAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
120 COON DEN RD, HIGHLAND LAKES, NJ 07422-2078
(973) 617-6705
(201) 621-4346
Mailing address
120 COON DEN RD, HIGHLAND LAKES, NJ 07422-2078
(973) 617-6705
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-40755
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
474541987
—
NJ
Enumeration date
05/05/2020
Last updated
09/04/2020
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