Individual
DANA STUKENBROEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 PARKER ST STE 306, MAYNARD, MA 01754-2180
(888) 991-2103
Mailing address
141 PARKER ST STE 306, MAYNARD, MA 01754-2180
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
37PC00699000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00699000
LICENSE
NJ
Enumeration date
03/16/2021
Last updated
03/16/2021
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