Provider Demographics
NPI:1710855135
Name:BUTLER, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2376
Mailing Address - Street 2:
Mailing Address - City:JULIAN
Mailing Address - State:CA
Mailing Address - Zip Code:92036-2376
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2485 WASHINGTON ST UNIT 8
Practice Address - Street 2:
Practice Address - City:JULIAN
Practice Address - State:CA
Practice Address - Zip Code:92036-9235
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-27
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst