| Doctor Name: | MISS STACY LYNN DUTKA |
| NPI Number: | 1295903375 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 130 Powerville Rd Boonton, NJ - 070058705 |
| Business Phone Number: | 9733161816 |
| Business Fax Number: | |
| Mailing Address: | 75 Stryker Ct, BRIDGEWATER |
| State: | NJ |
| Postal Code: | 088071671 |
| Phone Number: | 8562977081 |
| Fax Number: | |
| NPI Enumeration Date: | 02/12/2008 |
| NPI Last Update Date: | 06/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |