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General NPI Number Information
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NPI Number | 1730105685
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Entity Type | Individual
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Provider Name | SCOTT JAY LEONARD M.A., L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3781 MARIPOSA ST. #3
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4675
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Country | US
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Telephone | 719-264-9660
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Fax | 225-410-6769
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Provider Business Mailing Address
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Address Line | 3781 MARIPOSA ST., #3
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4675
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Country | US
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Telephone | 719-264-9660
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Fax | 225-410-6769
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 909
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License Number State | CO
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