Individual
STEPHANIE JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
121 ETTRICK ST, BROCKTON, MA 02301-5803
(781) 201-0593
Mailing address
121 ETTRICK ST, BROCKTON, MA 02301-5803
(781) 201-0593
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
S190465
MA
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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