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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