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Individual

LESLIE STORK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
20 ARROWOOD DR, ITHACA, NY 14850-1869
(607) 274-4322
(607) 274-4587
Mailing address
20 ARROWOOD DR, ITHACA, NY 14850-1869

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
367A00000X
Advanced Practice Midwife
Primary
4704306112
MI

Other

Enumeration date
09/24/2018
Last updated
01/08/2021
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