Individual
KATHRYN NAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
526 OLD LIVERPOOL RD, LIVERPOOL, NY 13088-6238
(315) 453-3911
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4523
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
36772
NY
164W00000X
Licensed Practical Nurse
280612
NY
374U00000X
Home Health Aide
280612-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
12/23/2013
Last updated
03/14/2024
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