Provider Demographics
NPI:1629600861
Name:STABILE, DENISE LEBLANC
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:LEBLANC
Last Name:STABILE
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 1:270 BRIDGE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1798
Mailing Address - Country:US
Mailing Address - Phone:781-329-0909
Mailing Address - Fax:
Practice Address - Street 1:270 BRIDGE ST STE 301
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1798
Practice Address - Country:US
Practice Address - Phone:781-329-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker