| NPI | 1235929621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY M STACK Dnp, Pmhnp Bc 518-952-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-06-02 |