Provider Demographics
NPI:1255008751
Name:LEIDT, ALEXANDRIA E (BCBA)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:E
Last Name:LEIDT
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 1:7500 SAN FELIPE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1707
Mailing Address - Country:US
Mailing Address - Phone:281-826-3382
Mailing Address - Fax:
Practice Address - Street 1:102 S TEJON ST STE 1100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2253
Practice Address - Country:US
Practice Address - Phone:719-733-3824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst