Provider Demographics
NPI:1972749729
Name:LEO, KRISTIN (BEHAVIOR SPECIALIST)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:LEO
Suffix:
Gender:F
Credentials:BEHAVIOR SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ACADEMY RD.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-431-1650
Mailing Address - Fax:518-447-0429
Practice Address - Street 1:102 HACKETT BLVD.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12209
Practice Address - Country:US
Practice Address - Phone:518-431-1650
Practice Address - Fax:518-447-0429
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor