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Individual

LEIBA BOBB-MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
600 FRANKLIN ST STE 204, SCHENECTADY, NY 12305-2107
(518) 372-7031
Mailing address
79 GLENRIDGE RD, SCHENECTADY, NY 12302-4528

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000000
NY
05
01420800
NY
Enumeration date
09/08/2022
Last updated
09/26/2022
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