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General NPI Number Information
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NPI Number | 1841504602
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Entity Type | Individual
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Provider Name | MISS LEIGH WILKES EDGERTON
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Gender | Female
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Dates
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Enumeration Date | 08/03/2010
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Last Update Date | 04/12/2017
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Provider Practice Location Address
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Address Line | 1664 HARRISON ST
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City | DENVER
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State | CO
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Zip | 80206-1919
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Country | US
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Telephone | 303-913-8112
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Fax |
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Provider Business Mailing Address
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Address Line | 1664 HARRISON ST
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City | DENVER
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State | CO
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Zip | 80206-3417
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Country | US
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Telephone | 303-913-8112
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Fax |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 11725151
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License Number State | CO
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