Doctor Name: | MS. SALLY STORMON |
NPI Number: | 1013071505 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 000416-1 |
Business Practice Address: | 17 E Genesee St Auburn, NY - 130214040 |
Business Phone Number: | 3152539795 |
Business Fax Number: | 3152534316 |
Mailing Address: | 233 S Seward Ave, AUBURN |
State: | NY |
Postal Code: | 130214221 |
Phone Number: | 5188488483 |
Fax Number: | |
NPI Enumeration Date: | 12/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 000416-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |