Basic Information
| Provider Information | |||||||||
| NPI: | 1952526279 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STERN | ||||||||
| FirstName: | EVELYN | ||||||||
| MiddleName: | FRANCES | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CCC-SP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 36 CUTLER ST | ||||||||
| Address2: | APT.1 | ||||||||
| City: | WINTHROP | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021521281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175391770 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 530 BORDER ST | ||||||||
| Address2: | |||||||||
| City: | EAST BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021282432 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6175696560 | ||||||||
| FaxNumber: | 6175691856 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 1879 | MA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.