Provider Demographics
NPI:1528651387
Name:LEON, CYNTHIA (MS)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:LEON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7043 E 38TH PL
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-1441
Mailing Address - Country:US
Mailing Address - Phone:213-562-9926
Mailing Address - Fax:
Practice Address - Street 1:3939 S AVENUE 3 E
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-5512
Practice Address - Country:US
Practice Address - Phone:919-899-0313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-12
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-23-66742103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst