Individual
STACY ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22004 LINDEN BLVD, CAMBRIA HEIGHTS, NY 11411-1621
(718) 712-3358
Mailing address
1672 RALPH AVE APT 1B, BROOKLYN, NY 11236-3331
(646) 509-3705
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
712826
NY
Other
Enumeration date
03/13/2014
Last updated
03/13/2014
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