Provider Demographics
NPI:1811881378
Name:SUAREZ PANTALEON, DEANNA DE LA CARIDAD
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:DE LA CARIDAD
Last Name:SUAREZ PANTALEON
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 1:5745 W ROCHELLE AVE APT 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3449
Mailing Address - Country:US
Mailing Address - Phone:702-720-8504
Mailing Address - Fax:
Practice Address - Street 1:5745 W ROCHELLE AVE APT 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-3449
Practice Address - Country:US
Practice Address - Phone:702-720-8504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-25-442695106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician