Most Relevant Information
Provider Data
| NPI Number: | 1003584830 |
| Provider Name: | LEA LESLIE COOGAN NONE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/06/2021 |
| Last Updated: | 08/15/2022 |
Provider Practice Location
350 FAIRWAY DR STE 101
DEERFIELD BEACH
FL
334411834
Practice Location Phone/Fax
| Phone: | 8774182978 |
| Fax: | 8665002186 |
Provider Mailing Location
18726 S WESTERN AVE
GARDENA
CA
902483813
Provider Mailing Phone/Fax
| Phone: | 3108560800 |
| Fax: | 8555682494 |