Individual
ABIGAIL STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45 ATWATER RD, LANSING, NY 14882
(607) 592-5977
Mailing address
45 ATWATER RD, LANSING, NY 14882-9096
(607) 592-5977
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
081205
NY
1041C0700X
Clinical Social Worker
Primary
081205
NY
Other
Enumeration date
10/06/2015
Last updated
09/19/2019
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