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Individual

MR. BRETT ALAN STAPLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
556 CLINTON AVE S, ROCHESTER, NY 14620-1105
(585) 442-8422
(585) 442-8494
Mailing address
79 GLENRIDGE RD, GLENVILLE, NY 12302-4528
(585) 368-6900

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01420800
NY
Enumeration date
04/02/2021
Last updated
08/30/2022
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