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General NPI Number Information
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NPI Number | 1790808491
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Entity Type | Individual
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Provider Name | LESLIE L WAY LPC
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 179 WILD ROSE DR
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-8635
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Country | US
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Telephone | 970-379-4976
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Fax | 970-945-5387
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Provider Business Mailing Address
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Address Line | 179 WILD ROSE DR
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City | GLENWOOD SPRINGS
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State | CO
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Zip | 81601-8635
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Country | US
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Telephone | 970-379-4976
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Fax | 970-945-5387
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2630
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License Number State | CO
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