Individual
MISS LEAH DENISE PRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.ED
Contact information
Practice address
1661 CASTLETON AVE, STATEN ISLAND, NY 10302-1215
(347) 552-2729
Mailing address
1661 CASTLETON AVE, STATEN ISLAND, NY 10302-1215
(347) 552-2729
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1214771
NY
Other
Enumeration date
11/16/2014
Last updated
11/16/2014
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