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General NPI Number Information
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NPI Number | 1811510274
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Entity Type | Individual
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Provider Name | NICHOLE STONE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | 617 S 10TH AVE
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City | STERLING
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State | CO
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Zip | 80751-3426
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Country | US
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Telephone | 970-522-7121
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Fax |
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Provider Business Mailing Address
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Address Line | 19349 COUNTY ROAD 25 LOT 12
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City | BRUSH
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State | CO
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Zip | 80723-9722
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Country | US
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Telephone | 970-842-4500
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 001803
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0001803
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License Number State | CO
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