Individual
STACY ABRAHAM PATTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
61 LAWTON AVE, HARTSDALE, NY 10530-2524
(919) 280-9082
Mailing address
61 LAWTON AVE, HARTSDALE, NY 10530-2524
(919) 280-9082
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004283-1
NY
225700000X
Massage Therapist
023033-1
NY
Other
Enumeration date
02/16/2012
Last updated
02/01/2023
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