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Organization
INDIVIDUAL PROVIDER
Active
Organization
INDIVIDUAL PROVIDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA D LETO M.A. (THERAPIST)
(970) 618-6796
Entity
Organization
Contact information
Practice address
4159 LOWELL BLVD, DENVER, CO 80211-1658
(303) 458-7220
Mailing address
2800 KALMIA AVE, #A204, BOULDER, CO 80301-1542
(970) 618-6796
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
NLC.0105326
CO
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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