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General NPI Number Information
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NPI Number | 1457556219
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Entity Type | Individual
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Provider Name | ELIZABETH STONE PHD
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Gender | Female
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 329 BATH RD
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City | BRUNSWICK
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State | ME
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Zip | 04011-2609
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Country | US
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Telephone | 800-434-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 115 HARBOR PL
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2861
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PS1060
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License Number State | ME
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