Provider Demographics
NPI:1205683604
Name:GERIK, LESLEY (RBT)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:GERIK
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SANGER AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5866
Mailing Address - Country:US
Mailing Address - Phone:254-848-6284
Mailing Address - Fax:
Practice Address - Street 1:578 S WHEAT RD
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-7134
Practice Address - Country:US
Practice Address - Phone:254-644-2423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician