Provider Demographics
NPI:1477855518
Name:BOYER, STEFANIE WOLFE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:WOLFE
Last Name:BOYER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:
Other - Last Name:WOLFE BOYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2 REHABILITATION WAY
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6003
Mailing Address - Country:US
Mailing Address - Phone:781-939-1913
Mailing Address - Fax:781-933-9257
Practice Address - Street 1:305 CENTRE ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1719
Practice Address - Country:US
Practice Address - Phone:617-424-4848
Practice Address - Fax:617-244-8312
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7982235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist