Provider Demographics
NPI:1033524145
Name:ABDULLAH-ALLEN, LEONA (MA)
Entity Type:Individual
Prefix:
First Name:LEONA
Middle Name:
Last Name:ABDULLAH-ALLEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LAKEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-2617
Mailing Address - Country:US
Mailing Address - Phone:719-209-1073
Mailing Address - Fax:
Practice Address - Street 1:411 LAKEWOOD CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:TERRITORY
Practice Address - Zip Code:80910
Practice Address - Country:UM
Practice Address - Phone:719-209-1073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC0007932101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health