Provider Demographics
NPI:1558711291
Name:LEON, VIOLETA RUBY (MS, LMFT)
Entity type:Individual
Prefix:
First Name:VIOLETA
Middle Name:RUBY
Last Name:LEON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 N ALAMEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-2130
Mailing Address - Country:US
Mailing Address - Phone:575-405-7146
Mailing Address - Fax:575-505-5446
Practice Address - Street 1:101 N ALAMEDA BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2610
Practice Address - Country:US
Practice Address - Phone:915-274-5301
Practice Address - Fax:575-405-5446
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMF0200801106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist