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Organization
MIND AND BODY INTEGRATION, PLLC
Active
Organization
MIND AND BODY INTEGRATION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY R LEIBLI DNP (DNP, FNP-BC, PMHNP-BC)
(719) 430-5650
Entity
Organization
Contact information
Practice address
109 LATIGO LN STE G, CANON CITY, CO 81212-8113
(719) 430-5650
(719) 345-0607
Mailing address
265 7TH ST, PENROSE, CO 81240-9312
(719) 430-5650
(719) 345-0607
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/11/2021
Last updated
02/21/2023
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