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ABIGAIL STARK

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1144690959

Individual Registrant:
 ABIGAIL  STARK 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
45 ATWATER RD  LANSING, NY 14882 US
Tel: 607-592-5977  Fax: --

Contact information for business:
45 ATWATER RD  LANSING, NY 14882-9096 US
Tel: 607-592-5977  Fax: --

Registration Information:
NPI: 1144690959
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
NY081205
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker
NY081205

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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