Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor | ||
N | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1841525029 |
---|---|
Provider Name | Stacie Weldon |
First Address | Elmont, NY 11003 |
Second Address | Elmont, NY 11003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2009 |
Last Update Date | 26/12/2012 |