Individual
LEONEL LASANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
CALLE 2 KM 11.8 EDIFICIO CENTURION PISO 3, BAYAMON, PR 00961
(787) 704-0705
Mailing address
120 MAPLE ST, SPRINGFIELD, MA 01103-2203
(413) 846-0445
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
7010
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295
—
MA
Enumeration date
12/02/2016
Last updated
07/26/2021
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