Individual
MS. MARIA HELEN STACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.M.
Contact information
Practice address
55 DIMOCK ST, ROXBURY, MA 02119-1029
(617) 442-8800
Mailing address
55 DIMOCK ST, ROXBURY, MA 02119-1029
(617) 442-8800
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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