Provider Demographics
NPI:1679629729
Name:STOLER, LINDA RIBBLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:RIBBLE
Last Name:STOLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 NORTH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1654
Mailing Address - Country:US
Mailing Address - Phone:508-359-1144
Mailing Address - Fax:
Practice Address - Street 1:50 NORTH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-1654
Practice Address - Country:US
Practice Address - Phone:508-359-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8082103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW06376OtherBLUE CROSS BLUE SHIELD
MAW51341Medicare ID - Type Unspecified