National Provider Identifier

Stacey Johnson

Stacey Johnson is listed in the NPPES registry with a primary specialty of Early Intervention Provider Agency in Olean, NY and a listed phone number of (716) 938-2478.

NPI 1154219293Olean, NYEarly Intervention Provider Agency

Profile Overview

NPI
1154219293
Provider Type
Individual
Primary Specialty
Early Intervention Provider Agency
Enumeration Date
June 26, 2025
Last Updated
June 27, 2025

Practice Location

  • 1 Leo Moss Dr
  • Olean, NY 14760-1100

Phone: (716) 938-2478

Specialties

  • Early Intervention Provider Agency (252Y00000X)
Full Record
NPI
1154219293
Entity Type
Individual
Last Name
Johnson
First Name
Stacey
Mailing Street Address
1 Leo Moss Dr
Mailing City
Olean
Mailing State
NY
Mailing ZIP Code
14760-1100
Mailing Country
US
Practice Street Address
1 Leo Moss Dr
Practice City
Olean
Practice State
NY
Practice ZIP Code
14760-1100
Practice Country
US
Practice Phone
(716) 938-2478
Enumeration Date
June 26, 2025
Last Updated
June 27, 2025
Sex
Female
Sole Proprietor
Yes
Certification Date
June 27, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Early Intervention Provider Agency (252Y00000X)