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General NPI Number Information
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NPI Number | 1669538146
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Entity Type | Individual
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Provider Name | HELENA YOLANDA STAUBER ED.D.
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Gender | Female
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4 MILITIA DR SUITE 23
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City | LEXINGTON
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State | MA
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Zip | 02421-4737
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Country | US
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Telephone | 617-513-1775
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Fax |
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Provider Business Mailing Address
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Address Line | 118 WYMAN RD
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City | BILLERICA
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State | MA
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Zip | 01821-3740
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Country | US
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Telephone | 617-513-1775
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 7075
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License Number State | MA
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