Individual
PAMELA LEAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
88 HENDRICKSON AVE, RVC, NY 11570
(516) 492-5416
Mailing address
88 HENDRICKSON AV, ROCKVILLE CENTRE, NY 11570
(516) 492-5416
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14-754
NY
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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