Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 2229 | MA |
N | 103TC0700X | Clinical Psychologist | 2229 | MA |
N | 103TE1100X | Exercise & Sports Psychologist | 2229 | MA |
N | 103TH0100X | Health Service | 2229 | MA |
N | 103TR0400X | Rehabilitation Psychologist | 2229 | MA |
NPI | 1003965534 |
---|---|
Provider Name | Dr. Diane Stoler |
First Address | Boxford, MA 01921-1240 |
Second Address | Boxford, MA 01921-1240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2007 |
Last Update Date | 08/07/2007 |