Individual
MARTHA J LE BLANC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 MAIN ST, MINEOLA, NY 11501-4000
(516) 747-5644
(516) 747-2556
Mailing address
110 MAIN ST, MINEOLA, NY 11501-4000
(516) 747-5644
(516) 747-2556
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
11932
NY
Other
Enumeration date
03/17/2014
Last updated
03/17/2014
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