Healthcare Provider Details

I. General information

NPI: 1275656878
Provider Name (Legal Business Name): REBECCA L STONE L.M.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2916 PASAJE DEL HERRERO
SANTA FE NM
87505-6529
US

IV. Provider business mailing address

2916 PASAJE DEL HERRERO
SANTA FE NM
87505-6529
US

V. Phone/Fax

Practice location:
  • Phone: 505-690-2624
  • Fax:
Mailing address:
  • Phone: 505-820-2988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number2945
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: