Provider Demographics
NPI:1932619244
Name:DE LEON, CATHERINA MACIAL
Entity Type:Individual
Prefix:
First Name:CATHERINA
Middle Name:MACIAL
Last Name:DE LEON
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 1:12995 SW 133RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6965
Mailing Address - Country:US
Mailing Address - Phone:786-413-9451
Mailing Address - Fax:
Practice Address - Street 1:12995 SW 133RD TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6965
Practice Address - Country:US
Practice Address - Phone:786-413-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst