Individual
BENJAMIN BAKER STAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
300 W MAIN ST, BUILDING B, NORTHBOROUGH, MA 01532-2132
(978) 310-1041
Mailing address
68 BENNETT ST, HUDSON, MA 01749
(978) 310-1041
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
119392
MA
Other
Enumeration date
09/22/2011
Last updated
03/16/2016
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