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General NPI Number Information
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NPI Number | 1891822110
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Entity Type | Individual
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Provider Name | LESLIE HANNON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 80 GARDEN CTR STE 320
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City | BROOMFIELD
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State | CO
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Zip | 80020-1735
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Country | US
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Telephone | 720-560-4016
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Fax |
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Provider Business Mailing Address
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Address Line | 80 GARDEN CTR STE 320
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City | BROOMFIELD
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State | CO
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Zip | 80020-1735
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Country | US
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Telephone | 720-933-2408
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3493
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License Number State | CO
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