Provider Demographics
NPI:1861710899
Name:CHESTER, LEIGH ANNE (BCBA)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANNE
Last Name:CHESTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:GLEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:11454 127TH AVE
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-1913
Mailing Address - Country:US
Mailing Address - Phone:727-742-7872
Mailing Address - Fax:877-271-9338
Practice Address - Street 1:11454 127TH AVE
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-1913
Practice Address - Country:US
Practice Address - Phone:727-742-7872
Practice Address - Fax:877-271-9338
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-13-12719103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017472400Medicaid