Provider Demographics
NPI:1477268407
Name:STUMPF, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:STUMPF
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:STUMPF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NBC-HWC, RDH
Mailing Address - Street 1:45 BROOK ST
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-2144
Mailing Address - Country:US
Mailing Address - Phone:781-245-5290
Mailing Address - Fax:
Practice Address - Street 1:27 WATER ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-3032
Practice Address - Country:US
Practice Address - Phone:781-864-6908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty