Healthcare Provider Details

I. General information

NPI: 1013464403
Provider Name (Legal Business Name): MARY-KATHERINE STONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2016
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 COLLEGE ST APT C-6
BURLINGTON VT
05401-8343
US

IV. Provider business mailing address

228 MAPLE ST APT 6
BURLINGTON VT
05401-4552
US

V. Phone/Fax

Practice location:
  • Phone: 205-353-2142
  • Fax:
Mailing address:
  • Phone: 205-353-2142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: