Provider Demographics
NPI:1477048940
Name:SENN-CADOTTE, LEAH
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SENN-CADOTTE
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 1:3082 QUARTERLAND ST
Mailing Address - Street 2:
Mailing Address - City:STRASBURG
Mailing Address - State:CO
Mailing Address - Zip Code:80136-7422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:323 BOULDER HILL PASS
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-9402
Practice Address - Country:US
Practice Address - Phone:815-347-4353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18-57409106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician