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1174890396
LEONARDA WALLACE
STATEN ISLAND, NY
NPI
1174890396
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: NY 7629418)
Enumeration Date
2011-11-17
Last Update Date
2016-02-12
Business Address
Mrs. LEONARDA WALLACE OTR/L
218 EDGEGROVE AVE
STATEN ISLAND, NY 10312-3512
Phone number: 718-873-7713
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Mailing Address
Mrs. LEONARDA WALLACE OTR/L
218 EDGEGROVE AVE
STATEN ISLAND, NY 10312-3512
Phone number: 718-873-7713
Copy
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