Provider Demographics
NPI:1114768223
Name:ANTENOR, LEANNA MARIA ASUNCION
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:MARIA ASUNCION
Last Name:ANTENOR
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 1:2551 S FORT APACHE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8700
Mailing Address - Country:US
Mailing Address - Phone:702-385-0920
Mailing Address - Fax:
Practice Address - Street 1:1701 N GREEN VALLEY PKWY STE 9B
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-5991
Practice Address - Country:US
Practice Address - Phone:725-444-3803
Practice Address - Fax:702-441-0356
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician