Healthcare Provider Details

I. General information

NPI: 1457212821
Provider Name (Legal Business Name): LEIGHANN HOBBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N MAIN ST STE 654
PUEBLO CO
81003-3132
US

IV. Provider business mailing address

4149 OUTLOOK BLVD UNIT G
PUEBLO CO
81008-2616
US

V. Phone/Fax

Practice location:
  • Phone: 719-766-9362
  • Fax: 719-826-8183
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0024012
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: