Provider Demographics
NPI:1376328096
Name:ARISTILDE, LEANDRA SARAH
Entity Type:Individual
Prefix:
First Name:LEANDRA
Middle Name:SARAH
Last Name:ARISTILDE
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 1:1200 AVENUE B APT 623
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1336
Mailing Address - Country:US
Mailing Address - Phone:516-329-1474
Mailing Address - Fax:
Practice Address - Street 1:314 E HIGHLAND MALL BLVD STE 301
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-3731
Practice Address - Country:US
Practice Address - Phone:516-329-1474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health