Organization
LEADING EDGE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE MARIE LOOR PHD (OWNER)
(417) 501-9423
Entity
Organization
Contact information
Practice address
102 GOLD AVE SW # 256, ALBUQUERQUE, NM 87102-3335
(417) 501-9423
(505) 672-7769
Mailing address
PO BOX 45681, RIO RANCHO, NM 87174-5681
(505) 226-1960
(505) 672-7769
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/22/2025
Last updated
01/22/2025
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