Provider Demographics
NPI:1063191294
Name:TUASON, ALEXANDRA PATRICIA BUENO (BCBA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA PATRICIA
Middle Name:BUENO
Last Name:TUASON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ALEXANDRA PATRICIA
Other - Middle Name:TARRAYO
Other - Last Name:BUENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1707 VILLAGE CENTER CIR STE 140
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-0577
Mailing Address - Country:US
Mailing Address - Phone:718-215-5311
Mailing Address - Fax:718-865-5165
Practice Address - Street 1:1707 VILLAGE CENTER CIR STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-0577
Practice Address - Country:US
Practice Address - Phone:718-215-5311
Practice Address - Fax:718-865-5165
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-23-65735103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst