Individual
MS. STEPHANIE WAMBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 GREEN ST # 2, DUDLEY, MA 01571-3210
(413) 717-7017
Mailing address
20 GREEN ST # 2, DUDLEY, MA 01571-3210
(141) 371-7701
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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