Provider Demographics
NPI:1720776636
Name:SANCHEZ, LESLIE LISSETT
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:LISSETT
Last Name:SANCHEZ
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 1:631 LUCERNE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-3820
Mailing Address - Country:US
Mailing Address - Phone:561-529-0899
Mailing Address - Fax:
Practice Address - Street 1:631 LUCERNE AVE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33460-3820
Practice Address - Country:US
Practice Address - Phone:561-529-0899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician