Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 9180 | MA |
Y | 103G00000X | Clinical Psychologist | 9180 | MA |
Y | 103TC0700X | Clinical Psychologist | 9180 | MA |
NPI | 1104053933 |
---|---|
Provider Name | Dr. Stella Bitran |
First Address | Burlington, MA 01803-5202 |
Second Address | Burlington, MA 01803-5202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2009 |
Last Update Date | 09/06/2011 |