MEDICARE: ALFRED STONE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1518332014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFRED STONE

Provider Business Mailing Address
First Line	:	10211 RED PUEBLO PL
Second Line	:	UNIT 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-7013
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10211 RED PUEBLO PL
Second Line	:	UNIT 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89144-7013
Country	:	US
Telephone Number	:	562-761-4958
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2015
Last Update Date	:	12/09/2015

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Directions to “ ALFRED STONE ” Practice Location

Language	Start Address	Practice Location

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