Provider Demographics
NPI:1194930065
Name:STEIN, JUDITH ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:STEIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9 BERTRAND RD
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02466-2903
Mailing Address - Country:US
Mailing Address - Phone:781-861-3711
Mailing Address - Fax:781-861-3701
Practice Address - Street 1:125 HARTWELL AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-3100
Practice Address - Country:US
Practice Address - Phone:781-861-3711
Practice Address - Fax:781-861-3701
Is Sole Proprietor?:No
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6447103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist