Provider Demographics
NPI:1821691098
Name:FLAGG-PARTE, LEIGHANN (BCBA, MED, RBT)
Entity Type:Individual
Prefix:
First Name:LEIGHANN
Middle Name:
Last Name:FLAGG-PARTE
Suffix:
Gender:F
Credentials:BCBA, MED, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ENTERPRISE PL STE 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-8207
Mailing Address - Country:US
Mailing Address - Phone:302-678-3353
Mailing Address - Fax:302-678-9245
Practice Address - Street 1:100 ENTERPRISE PL STE 1
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-8207
Practice Address - Country:US
Practice Address - Phone:302-678-3353
Practice Address - Fax:302-678-9245
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-19
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103TF0000X, 103K00000X
DE106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty