Healthcare Provider Details

I. General information

NPI: 1679866206
Provider Name (Legal Business Name): JILL STONE OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 METACOM AVE RM A
WARREN RI
02885-2711
US

IV. Provider business mailing address

426 METACOM AVE RM A
WARREN RI
02885-2711
US

V. Phone/Fax

Practice location:
  • Phone: 401-400-2121
  • Fax: 401-445-0221
Mailing address:
  • Phone: 401-400-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberOTA00540
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT01891
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: