Provider Demographics
NPI:1003197351
Name:LEHR-FIZER, JOLE (BCBA, CTRS)
Entity Type:Individual
Prefix:
First Name:JOLE
Middle Name:
Last Name:LEHR-FIZER
Suffix:
Gender:F
Credentials:BCBA, CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 W NORTH LOOP BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2004
Mailing Address - Country:US
Mailing Address - Phone:512-524-5482
Mailing Address - Fax:512-524-1177
Practice Address - Street 1:1509 W NORTH LOOP BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2004
Practice Address - Country:US
Practice Address - Phone:512-524-5482
Practice Address - Fax:512-524-1177
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-06-2779103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst