Provider Demographics
NPI:1629437884
Name:STEMMLER, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:STEMMLER
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 1:10 SHAWNEE DR
Mailing Address - Street 2:SUITE B2
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-5803
Mailing Address - Country:US
Mailing Address - Phone:917-359-2503
Mailing Address - Fax:
Practice Address - Street 1:10 SHAWNEE DR
Practice Address - Street 2:SUITE B2
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-5803
Practice Address - Country:US
Practice Address - Phone:917-359-2503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL053311001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical