Individual
MS. KIMBERLY MARIE LEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASACT 25829
Contact information
Practice address
1734 ADAMS ST # 1, BRONX, NY 10460-2609
(646) 539-0264
Mailing address
1734 ADAMS ST # 1, BRONX, NY 10460-2609
(646) 539-0264
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NY
Other
Enumeration date
10/14/2013
Last updated
10/14/2013
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