Healthcare Provider Details

I. General information

NPI: 1316137847
Provider Name (Legal Business Name): DANIELLE STONE LCMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 RHOMBERG AVE
DUBUQUE IA
52001-3424
US

IV. Provider business mailing address

3250 JFK RD
DUBUQUE IA
52002-3250
US

V. Phone/Fax

Practice location:
  • Phone: 563-580-5630
  • Fax:
Mailing address:
  • Phone: 563-583-3629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: