Provider Demographics
NPI:1386377943
Name:CLAY, LEANN MARIE (LMT)
Entity type:Individual
Prefix:MRS
First Name:LEANN
Middle Name:MARIE
Last Name:CLAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4327 S NEPAL CT
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6832
Mailing Address - Country:US
Mailing Address - Phone:559-999-3884
Mailing Address - Fax:
Practice Address - Street 1:SOLA SALON 1265 SGT JON STILES DRIVE
Practice Address - Street 2:SPA SUITE #7
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129
Practice Address - Country:US
Practice Address - Phone:720-326-1256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0017238225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist