Individual
DR. LEOTA SUSAN BRANCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1651 THIRD AVENUE, IPTAR, NY, NY 10128
(914) 262-3985
(914) 723-2731
Mailing address
10 OLD JACKSON AVE UNIT 19, HASTINGS ON HUDSON, NY 10706-3231
(914) 262-3985
(914) 723-2731
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
009665-1
NY
103TC0700X
Clinical Psychologist
009665
NY
103TC0700X
Clinical Psychologist
Primary
0096651
NY
Other
Enumeration date
07/28/2008
Last updated
01/09/2017
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