Leeanna Marie Grondin
Individual provider Active NPI Behavior Technician · Raton, NM
NPI 1609600402 · NPPES record last updated Aug 26, 2024
Key facts
- NPI
- 1609600402
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-24-372396 (NM)
- Practice address
- 243 Cook Ave
Raton, NM 87740-3930 - Phone
- (580) 319-5770
- Fax
- (580) 319-7086
- NPI assigned
- Aug 26, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-372396 | NM | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-372396 | NM | Yes |
Addresses
Primary practice location
243 Cook Ave
Raton, NM 87740-3930
Mailing address
PO Box 796
Raton, NM 87740-0796
Phone (580) 319-5770
Other providers in Raton, NM
- Shannon Garrett
- Heather L Glasman
- Chicky Gomez
- Jessie Gomez
- Janice L Grine
- Casey Grubelnik
- Deyton Guara
- Patricia Guereca
- Chantle Gutierrez
- Ernest E. Haecker
All providers in Raton, NM · Behavior Technician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.