Provider Demographics
NPI:1073710372
Name:LALLIER, STEPHANIE ANNE
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ANNE
Last Name:LALLIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 PARKER ST
Mailing Address - Street 2:UNIT 203
Mailing Address - City:ROXBURY CROSSING
Mailing Address - State:MA
Mailing Address - Zip Code:02120-3000
Mailing Address - Country:US
Mailing Address - Phone:617-970-1899
Mailing Address - Fax:
Practice Address - Street 1:30 BOSTON ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-2540
Practice Address - Country:US
Practice Address - Phone:781-592-5691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor