Provider Demographics
NPI:1700428166
Name:STFLEUR, MARIE
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:STFLEUR
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 1:1 BROOKLINE PL APT 505
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4194
Mailing Address - Country:US
Mailing Address - Phone:857-277-9186
Mailing Address - Fax:
Practice Address - Street 1:1 BROOKLINE PL APT 505
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-4194
Practice Address - Country:US
Practice Address - Phone:857-277-9186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician