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General NPI Number Information
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NPI Number | 1083615116
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Entity Type | Individual
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Provider Name | STEPHANIE B. DRIEZE LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8 THORNDIKE ST
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City | BEVERLY
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State | MA
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Zip | 01915-5858
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Country | US
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Telephone | 978-462-2890
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Fax | 978-462-2890
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Provider Business Mailing Address
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Address Line | 143 STATE ST
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City | NEWBURYPORT
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State | MA
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Zip | 01950-6621
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Country | US
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Telephone | 978-462-2890
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Fax | 978-462-2890
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1018783
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License Number State | MA
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