Individual
GUSTAVO LEYVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC TRAINEE
Contact information
Practice address
117-11 MYRTLE AVENUE, RICHMOND HILL, NY 11418
(718) 849-6300
(718) 849-1093
Mailing address
117-11 MYRTLE AVENUE, RICHMOND HILL, NY 11418
(718) 849-6300
(718) 849-1093
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18554
NY
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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