Individual
LEAUDRA HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5873 US-219, ELLICOTTVILLE, NY 14731
(716) 669-2368
Mailing address
352 E STATE ST, SALAMANCA, NY 14779-1226
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
891094
NY
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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