Provider Demographics
NPI:1497591283
Name:SANCHEZ MUNETON, LESLIE
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:SANCHEZ MUNETON
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 1:2355 W LE MARCHE AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-4122
Mailing Address - Country:US
Mailing Address - Phone:623-688-6925
Mailing Address - Fax:
Practice Address - Street 1:6609 S 16TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-5815
Practice Address - Country:US
Practice Address - Phone:562-619-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-23-313164106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician