Provider Demographics
NPI:1477285419
Name:CANTU, ALEHA BUFFALOE (PHD)
Entity Type:Individual
Prefix:
First Name:ALEHA
Middle Name:BUFFALOE
Last Name:CANTU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131824
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77393-1824
Mailing Address - Country:US
Mailing Address - Phone:713-701-7792
Mailing Address - Fax:
Practice Address - Street 1:8111 ASHLANE WAY
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77382-2325
Practice Address - Country:US
Practice Address - Phone:713-701-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38173103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty