Individual
LESLIE MARIE PORTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCAT, ATR-BC
Contact information
Practice address
92 BROADWAY STE 200, GREENLAWN, NY 11740-1328
(516) 513-9313
Mailing address
38 BRAND DR, HUNTINGTON, NY 11743-4503
(516) 513-9313
Taxonomy
Speciality
Code
Description
License number
State
221700000X
Art Therapist
Primary
003005
NY
Other
Enumeration date
05/17/2022
Last updated
10/10/2024
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