Provider Demographics
NPI:1578873907
Name:GARSSON, STACEY HILLARY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:STACEY
Middle Name:HILLARY
Last Name:GARSSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 PARK AVE
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0808
Mailing Address - Country:US
Mailing Address - Phone:212-427-7667
Mailing Address - Fax:
Practice Address - Street 1:983 PARK AVE
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0808
Practice Address - Country:US
Practice Address - Phone:212-427-7667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009313-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist