Individual
MRS. LESLIE DETRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1031 ELM ST, PEEKSKILL, NY 10566-3401
(191) 473-7330
Mailing address
1031 ELM ST, PEEKSKILL, NY 10566-3401
(191) 473-7330
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1856017
NY
Other
Enumeration date
04/25/2012
Last updated
02/25/2013
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