Provider Demographics
NPI:1902967656
Name:HUNTLEY, GARY (CRC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:HUNTLEY
Suffix:
Gender:M
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:227 THORN AVE
Mailing Address - Street 2:SPECTRUM HUMAN SERVICES
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2600
Mailing Address - Country:US
Mailing Address - Phone:716-662-2040
Mailing Address - Fax:716-662-0019
Practice Address - Street 1:326 ORCHARD PARK RD
Practice Address - Street 2:SPECTRUM HUMAN SERVICES
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2635
Practice Address - Country:US
Practice Address - Phone:716-828-1719
Practice Address - Fax:716-828-9275
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY00006407225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor