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NPI 1043082266

NPI 1043082266 : LEIGH REINEKE THERAPY, LLC : FORT COLLINS, CO

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General NPI Number Information
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    NPI Number           |    1043082266
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    Entity Type          |    Organization 
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    Legal Business Name  |    LEIGH REINEKE THERAPY, LLC 
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Dates
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    Enumeration Date     |    10/23/2023
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    Last Update Date     |    10/23/2023
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Provider Practice Location Address
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    Address Line         |    1315 OAKRIDGE DR STE 100 
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    City                 |    FORT COLLINS
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    State                |    CO
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    Zip                  |    80525-7338
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    Country              |    US
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    Telephone            |    970-889-1910
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1945 BLUE YONDER WAY 
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    City                 |    FORT COLLINS
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    State                |    CO
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    Zip                  |    80525-1974
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     LEIGH  REINEKE 
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    Credential           |    LCSW
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    Telephone            |    970-999-4816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    
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    License Number State |    
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