Provider Demographics
NPI:1376763763
Name:STOLE, ANNE MARIE (DT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:STOLE
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2654 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2149
Mailing Address - Country:US
Mailing Address - Phone:708-895-3398
Mailing Address - Fax:708-895-3886
Practice Address - Street 1:26926 W HEMLOCK RD
Practice Address - Street 2:
Practice Address - City:CHANNAHON
Practice Address - State:IL
Practice Address - Zip Code:60410-3391
Practice Address - Country:US
Practice Address - Phone:630-267-5325
Practice Address - Fax:815-467-0257
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist