Provider Demographics
NPI:1285070847
Name:PAPE, AUDREY J
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:J
Last Name:PAPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HIGH ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2307
Mailing Address - Country:US
Mailing Address - Phone:518-885-6884
Mailing Address - Fax:
Practice Address - Street 1:125 HIGH ROCK AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2307
Practice Address - Country:US
Practice Address - Phone:518-885-6884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)