Individual
MRS. STACEY FARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 CHURCH ST, CUBA, NY 14727-1212
(716) 307-2780
Mailing address
5 CHURCH ST, CUBA, NY 14727-1212
(716) 307-2780
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
004165-1
NY
Other
Enumeration date
03/03/2017
Last updated
03/03/2017
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