Provider Demographics
NPI:1477928018
Name:STAYNER, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:STAYNER
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 1:7 BISHOP ST FL 2
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8323
Mailing Address - Country:US
Mailing Address - Phone:508-620-2422
Mailing Address - Fax:508-620-2472
Practice Address - Street 1:7 BISHOP ST FL 2
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8323
Practice Address - Country:US
Practice Address - Phone:508-620-2422
Practice Address - Fax:508-620-2472
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health