Provider Demographics
NPI:1043666159
Name:SCOTT CANTERO, TANESHA N
Entity Type:Individual
Prefix:
First Name:TANESHA
Middle Name:N
Last Name:SCOTT CANTERO
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 1:5229 INDIAN RIVER DR
Mailing Address - Street 2:#233
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-7493
Mailing Address - Country:US
Mailing Address - Phone:725-200-3972
Mailing Address - Fax:
Practice Address - Street 1:2110 E FLAMINGO RD
Practice Address - Street 2:#315
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5190
Practice Address - Country:US
Practice Address - Phone:702-227-0987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst