Provider Demographics
NPI:1952526279
Name:STERN, EVELYN FRANCES (CCC-SP)
Entity type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:FRANCES
Last Name:STERN
Suffix:
Gender:F
Credentials:CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CUTLER ST
Mailing Address - Street 2:APT.1
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1281
Mailing Address - Country:US
Mailing Address - Phone:617-539-1770
Mailing Address - Fax:
Practice Address - Street 1:530 BORDER ST
Practice Address - Street 2:
Practice Address - City:EAST BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-2432
Practice Address - Country:US
Practice Address - Phone:617-569-6560
Practice Address - Fax:617-569-1856
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1879235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist