Healthcare Provider Details

I. General information

NPI: 1003965534
Provider Name (Legal Business Name): DR. DIANE STOLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 WASHINGTON ST
BOXFORD MA
01921-1240
US

IV. Provider business mailing address

87 WASHINGTON ST
BOXFORD MA
01921-1240
US

V. Phone/Fax

Practice location:
  • Phone: 978-352-8269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2229
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103TE1100X
TaxonomyExercise & Sports Psychologist
License Number2229
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2229
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number2229
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: