Individual
LEAF COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1401 N CAYUGA ST, ITHACA, NY 14850-2101
(607) 274-1232
Mailing address
400 LAKE ST, ITHACA, NY 14850-2132
(607) 274-2131
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
095619
NY
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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