MEDICARE: DEADRA L STONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1275789828
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEADRA L STONE

Provider Business Mailing Address
First Line	:	111 APPERSON HTS
Second Line	:
City	:	MOUNT STERLING
State	:	KY
Zip	:	40353-1602
Country	:	US
Telephone Number	:	859-499-3406
Fax Number	:	859-498-5000

Provider Business Practice Location Address
First Line	:	111 APPERSON HTS
Second Line	:
City	:	MOUNT STERLING
State	:	KY
Zip	:	40353-1602
Country	:	US
Telephone Number	:	859-499-3406
Fax Number	:	859-498-5000

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/14/2008
Last Update Date	:	08/14/2008

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Directions to “ DEADRA L STONE ” Practice Location

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