Doctor Name: | STEPHANIE GREGORY |
NPI Number: | 1700276128 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | P95874 |
Business Practice Address: | 29 Fennell St Skaneateles, NY - 131521117 |
Business Phone Number: | 2155145060 |
Business Fax Number: | |
Mailing Address: | 113 Cayuga St, Po 360 UNION SPRINGS |
State: | NY |
Postal Code: | 131602403 |
Phone Number: | 2155145060 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2015 |
NPI Last Update Date: | 01/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | P95874 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |