Provider Demographics
NPI:1932989100
Name:LEON, MARIA LISSETH
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LISSETH
Last Name:LEON
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 1:11885 HOLLY LN STE 1&2
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3181
Mailing Address - Country:US
Mailing Address - Phone:240-222-7956
Mailing Address - Fax:
Practice Address - Street 1:11885 HOLLY LN STE 1&2
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-3181
Practice Address - Country:US
Practice Address - Phone:240-222-7956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician