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NPI Code Detail

MEDICARE: NEW LEAF HEALING LLC

MEDICARE: NEW LEAF HEALING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1972189769
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW LEAF HEALING LLC
Provider Business Mailing Address
First Line : 2401 CREEKWOOD DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-2033
Country : US
Telephone Number : 970-310-7799
Fax Number :
Provider Business Practice Location Address
First Line : 2401 CREEKWOOD DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-2033
Country : US
Telephone Number : 970-310-7799
Fax Number :
Authorized Official
Title or Position : LCSW
Name : SHAUNNA CHRISTIE OSTROM
Credential : LCSW
Telephone Number : 970-460-6356
Provider Enumeration Date : 03/22/2021
Last Update Date : 03/22/2021

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Directions to “NEW LEAF HEALING LLC ” Practice Location

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