Individual
PAIGE K PRENTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MM, CASAC
Contact information
Practice address
6301 INDUCON DR E, SANBORN, NY 14132-9014
(716) 731-2030
(716) 731-3010
Mailing address
6301 INDUCON DR E, SANBORN, NY 14132-9014
(716) 731-2030
(716) 731-3010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10920
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10920
CASAC
NY
Enumeration date
11/16/2006
Last updated
07/08/2007
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