Provider Demographics
NPI:1760627665
Name:VANLEEUWEN, ALISON M (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:M
Last Name:VANLEEUWEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 252
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-0252
Mailing Address - Country:US
Mailing Address - Phone:303-548-4795
Mailing Address - Fax:
Practice Address - Street 1:110 EAGLE CANYON CIR
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:CO
Practice Address - Zip Code:80540-5011
Practice Address - Country:US
Practice Address - Phone:303-548-4795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO01110546235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO85585271Medicaid