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NPI Code Detail

MEDICARE: LEAH NOELLE DESGEORGES M.A.

MEDICARE: LEAH NOELLE DESGEORGES M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1588985881
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH NOELLE DESGEORGES M.A.
Provider Business Mailing Address
First Line : 1850 E EGBERT ST STE 200
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-2484
Country : US
Telephone Number : 303-853-3623
Fax Number :
Provider Business Practice Location Address
First Line : 1850 E EGBERT ST STE 200
Second Line :
City : BRIGHTON
State : CO
Zip : 80601-2484
Country : US
Telephone Number : 303-853-3623
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2010
Last Update Date : 06/21/2010

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