Basic Information
| Provider Information | |||||||||
| NPI: | 1598199267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEON-BYRD | ||||||||
| FirstName: | ANGEL | ||||||||
| MiddleName: | MARIA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.ED. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3155 IRONHORSE DR | ||||||||
| Address2: | |||||||||
| City: | LAKE RIDGE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221921424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9176130984 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4301 N FEDERAL HWY, SUITE 2 SOUTH | ||||||||
| Address2: | BUTTERFLY EFFECTS LLC | ||||||||
| City: | POMPANO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8888809270 | ||||||||
| FaxNumber: | 9543420273 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2013 | ||||||||
| LastUpdateDate: | 08/29/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | VA | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.