Individual
MISS STEPHANIE L URBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
115 GLENMORE AVENUE, CENTRAL ISLIP, NY 11722
(631) 647-3100
(631) 647-2058
Mailing address
115 GLENMORE AVENUE, CENTRAL ISLIP, NY 11722
(631) 647-3100
(631) 647-2058
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22035
NY
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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