Individual
MYA LEOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 WHITESBORO ST, UTICA, NY 13502-3015
(315) 724-5168
Mailing address
500 WHITESBORO ST, UTICA, NY 13502-3015
(315) 724-5168
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
—
NY
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
03/11/2026
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