MEDICARE: JENNIFER STONE CCC-SLP

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	235Z00000X	Speech-Language Pathologist	7646	NC

General Provider Information

NPI Number	:	1568882090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER STONE CCC-SLP

Provider Business Mailing Address
First Line	:	3222 BESSEMER DR
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-9041
Country	:	US
Telephone Number	:	252-754-0760
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 RIDGE TRL
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-1638
Country	:	US
Telephone Number	:	252-214-5408
Fax Number	:

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

Provider Enumeration Date	:	04/23/2014
Last Update Date	:	08/05/2019

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Directions to “ JENNIFER STONE CCC-SLP” Practice Location

Language	Start Address	Practice Location

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