Provider Demographics
NPI:1538808274
Name:BUENO, DEANNA (MA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:BUENO
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 S RAINBOW BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6234
Mailing Address - Country:US
Mailing Address - Phone:562-400-1334
Mailing Address - Fax:
Practice Address - Street 1:3140 S RAINBOW BLVD STE 400
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6234
Practice Address - Country:US
Practice Address - Phone:702-706-7635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLBA0648103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst