Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003124678 |
---|---|
Provider Name | Leah Stevens |
First Address | Norwood, MA 02062-3416 |
Second Address | Norwood, MA 02062-3416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2010 |
Last Update Date | 17/09/2010 |