| Doctor Name: | DR. BRUCE A. LEESON |
| NPI Number: | 1811910920 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | |
| Business Practice Address: | Evans Army Community Hospital Embedded Behavioral Health Team 5, Bldg 1226 Ft. Carson, CO - 80913 |
| Business Phone Number: | 7195037701 |
| Business Fax Number: | 7195268770 |
| Mailing Address: | 611 E Willamette Ave, COLORADO SPRINGS |
| State: | CO |
| Postal Code: | 809033030 |
| Phone Number: | 8163044061 |
| Fax Number: | 7195268770 |
| NPI Enumeration Date: | 07/26/2006 |
| NPI Last Update Date: | 04/03/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Forensic |
| Taxonomy Definition: | |