Doctor Name: | MRS. PATTY S. STICKNEY |
NPI Number: | 1417167073 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M. A. LCMHC |
License Number: | 0680000431 |
Business Practice Address: | 2 Shepards Lane Saxtons River, VT - 05154 |
Business Phone Number: | 8028696668 |
Business Fax Number: | 8028696652 |
Mailing Address: | 4 Hartley Hill Rd., P. O. Box 46 SAXTONS RIVER |
State: | VT |
Postal Code: | 05154 |
Phone Number: | 8028692024 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0680000431 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |