Individual
DR. STEPHANIE SHORT SIDNEY
Active
Individual
DR. STEPHANIE SHORT SIDNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3398
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007970
VALUE OPTIONS TAX ID
MA
01
—
34896
CIGNA
MA
01
—
44154653
TEAMSTERS TAX ID
MA
01
—
5134232
AETNA PIN #
MA
01
—
W03470
BC/BS PIN #
MA
Enumeration date
09/23/2006
Last updated
07/09/2007
Update your record
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