Individual
STACY PROSOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STACY PROSOWSKI
Contact information
Practice address
231 PARK DR, #22, BOSTON, MA 02215-4744
(555) 555-5555
Mailing address
231 PARK DR, BOSTON, MA 02215-4744
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/17/2008
Last updated
06/28/2013
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