Individual
MRS. MARY BERNADETTE SUTTON LEAVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
79 MIDDLEVILLE ROAD, NORTHPORT, NY 11768
(631) 261-4400
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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