Provider Demographics
NPI:1184050155
Name:STOECKLEY, LEANDRA CHANTRELLE (BCBA)
Entity type:Individual
Prefix:MISS
First Name:LEANDRA
Middle Name:CHANTRELLE
Last Name:STOECKLEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 S PINE ST STE 505
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7208
Mailing Address - Country:US
Mailing Address - Phone:916-307-9045
Mailing Address - Fax:
Practice Address - Street 1:4301 S PINE ST STE 505
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7208
Practice Address - Country:US
Practice Address - Phone:916-307-9045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-22
Last Update Date:2013-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst