Provider Demographics
NPI:1538571260
Name:STOLZER, MOLLIE
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:
Last Name:STOLZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 NEWTON ST APT 10
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-0454
Mailing Address - Country:US
Mailing Address - Phone:603-969-5795
Mailing Address - Fax:
Practice Address - Street 1:109 OAK STREET
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02464
Practice Address - Country:US
Practice Address - Phone:781-619-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist