Individual
STEPHANIE THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9 FORBES RD, WOBURN, MA 01801-2103
(781) 838-6757
(781) 939-6968
Mailing address
101 WILLOWWOOD ST APT 2, DORCHESTER, MA 02124-4040
(617) 905-2489
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LN86292
MA
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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