Provider Demographics
NPI:1316645195
Name:DALY, LEAH (CERT WELLNESS COACH)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:DALY
Suffix:
Gender:F
Credentials:CERT WELLNESS COACH
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 9955
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80932-0955
Mailing Address - Country:US
Mailing Address - Phone:720-698-6076
Mailing Address - Fax:
Practice Address - Street 1:12221 ANACOSTIA DR
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-8480
Practice Address - Country:US
Practice Address - Phone:720-698-6076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty