Individual
DEBORAH MANLEY-STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CIT
Contact information
Practice address
526 OLD LIVERPOOL RD, LIVERPOOL, NY 13088-6238
(315) 453-3911
(315) 453-0197
Mailing address
127 W OSTRANDER AVE, SYRACUSE, NY 13205-1923
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030008275
—
NY
Enumeration date
05/15/2013
Last updated
05/20/2021
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