Provider Demographics
NPI:1164189007
Name:COY, LESLIE ANNE
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANNE
Last Name:COY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 WAGON TRAIN DR
Mailing Address - Street 2:
Mailing Address - City:MILLIKEN
Mailing Address - State:CO
Mailing Address - Zip Code:80543-3021
Mailing Address - Country:US
Mailing Address - Phone:970-342-0670
Mailing Address - Fax:
Practice Address - Street 1:155 W HARVARD ST STE 401
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5200
Practice Address - Country:US
Practice Address - Phone:970-672-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-28
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty