Individual
COLLEEN STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1555 SUNRISE HWY, SUITE 4 MAILBOX 2, BAY SHORE, NY 11706-6027
(631) 666-1615
(631) 666-1709
Mailing address
PO BOX 725, GREAT RIVER, NY 11739-0725
(516) 589-1701
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000611
NY
Other
Enumeration date
02/22/2007
Last updated
06/27/2008
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