Individual
CAROL GARVIN-LEASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3780 S PARK AVE, BUFFALO, NY 14219-1805
(716) 926-1750
Mailing address
4339 BEETOW DRIVE, HAMBURG, NY 14075
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005320-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01390945
—
NY
Enumeration date
11/29/2011
Last updated
11/29/2011
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