Individual
DYAMOND GLEAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4091 BAYCHESTER AVE, BRONX, NY 10466-2313
(917) 969-6694
Mailing address
4091 BAYCHESTER AVE, BRONX, NY 10466-2313
(917) 969-6694
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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