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1164990347
STACY G PAGAN
STATEN ISLAND, NY
NPI
1164990347
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 24953)
Enumeration Date
2018-11-06
Last Update Date
2018-11-06
Business Address
Mrs. STACY G PAGAN
460 BRIELLE AVE
STATEN ISLAND, NY 10314-6427
Phone number: 917-439-6866
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Mailing Address
Mrs. STACY G PAGAN
460 BRIELLE AVE
STATEN ISLAND, NY 10314-6427
Phone number: 917-439-6866
Copy
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