Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 103K00000X | Behavior Analyst | 1-05-2308 | NC |
NPI | 1003053414 |
---|---|
Provider Name | Dr. Debra Leach |
First Address | Raleigh, NC 27607-6063 |
Second Address | Raleigh, NC 27607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2009 |
Last Update Date | 08/02/2021 |