Organization Name: | DIANE ROBERTS STOLER EDD, LLC |
NPI Number: | 1164662219 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DIANE R STOLER (CEO) |
Mailing Address: | 87 Washington St. Boxford |
State: | MA US |
Postal Code: | 019211240 |
Phone Number: | 9783526349 |
Fax Number: | 9783522835 |
NPI Enumeration Date: | 03/03/2009 |
NPI Last Update Date: | 03/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TE1100X |
License Number: | 2229 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Exercise & Sports |
Taxonomy Definition: |