Individual
MRS. DIANA LEBLANC CALICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
68 2ND AVE, APT C, NANUET, NY 10954-4405
(845) 536-2545
Mailing address
14 ROWAN DR, GARNERVILLE, NY 10923-1309
(845) 536-2545
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
820561
NY
164W00000X
Licensed Practical Nurse
323548
NY
Other
Enumeration date
10/13/2015
Last updated
06/04/2024
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