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Organization

A NEW LEAF THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REGAN YOUNG LCSW, CACIII (OWNER/PSYCHOTHERAPIST)
(719) 948-7120
Entity
Organization

Contact information

Practice address
315 COLORADO AVE, PUEBLO, CO 81004-2046
(719) 948-7120
(719) 289-7144
Mailing address
315 COLORADO AVE, PUEBLO, CO 81004-2046
(719) 948-7120
(719) 289-7144

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY3290
CO
261QM0850X
Adult Mental Health Clinic/Center
PSY3290
CO

Other

Enumeration date
05/06/2016
Last updated
05/06/2016
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