Provider Demographics
NPI:1689406613
Name:STERNER, DEEANA C (MED)
Entity type:Individual
Prefix:
First Name:DEEANA
Middle Name:C
Last Name:STERNER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 N. BROOKFEILD RD
Mailing Address - Street 2:PO BOX 304
Mailing Address - City:OAKHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01068-9806
Mailing Address - Country:US
Mailing Address - Phone:774-418-1454
Mailing Address - Fax:
Practice Address - Street 1:541 N. BROOKFEILD RD
Practice Address - Street 2:PO BOX 304
Practice Address - City:OAKHAM
Practice Address - State:MA
Practice Address - Zip Code:01068-9806
Practice Address - Country:US
Practice Address - Phone:774-418-1454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MABACB657123106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician