Provider Demographics
NPI:1891426060
Name:LECLAIRE, CHLOE JENSEN (MS)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:JENSEN
Last Name:LECLAIRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 E VINEDO LN
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1534
Mailing Address - Country:US
Mailing Address - Phone:480-772-2677
Mailing Address - Fax:
Practice Address - Street 1:3455 S CORONA ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2810
Practice Address - Country:US
Practice Address - Phone:303-761-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000980235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist