Individual
MISS LEANNE ELIZABETH INGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 E MAIN ST, EAST PATCHOGUE, NY 11772-3121
(631) 353-0219
Mailing address
36 RIDGE RD, SHIRLEY, NY 11967-2328
(631) 316-5984
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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