Healthcare Provider Details

I. General information

NPI: 1790255123
Provider Name (Legal Business Name): MISS TESS EMILY STONE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N WEST ST
DOYLESTOWN PA
18901-2366
US

IV. Provider business mailing address

16 3 POINT GARDEN RD
EAST STROUDSBURG PA
18301-9205
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-5300
  • Fax:
Mailing address:
  • Phone: 570-269-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010901
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: