Individual
MS. MARY GRACE LEONARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-R
Contact information
Practice address
250 HILLCREST RD, ITHACA, NY 14850-9747
(607) 279-9034
Mailing address
250 HILLCREST RD, ITHACA, NY 14850-9747
(607) 279-9034
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
069733
NY
1041S0200X
School Social Worker
Primary
539776041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
553866
VALUE OPTIONS
NY
Enumeration date
07/25/2007
Last updated
01/23/2012
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