Individual
MISS STACY LYNN DUTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 POWERVILLE RD, BOONTON, NJ 07005-8705
(973) 316-1816
Mailing address
75 STRYKER CT, BRIDGEWATER, NJ 08807-1671
(856) 297-7081
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/12/2008
Last updated
06/04/2010
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