MEDICARE: MS. WINDY LEE 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	146.012280	IL

General Provider Information

NPI Number	:	1922400159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. WINDY LEE STONE CCC-SLP

Provider Business Mailing Address
First Line	:	1419 CYPRESS ST
Second Line	:
City	:	HIGHLAND
State	:	IL
Zip	:	62249-2104
Country	:	US
Telephone Number	:	618-799-1297
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 CLINTON ST
Second Line	:
City	:	CARLYLE
State	:	IL
Zip	:	62231-1503
Country	:	US
Telephone Number	:	618-594-8826
Fax Number	:	618-594-8826

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

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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Directions to “ MS. WINDY LEE STONE CCC-SLP” Practice Location

Language	Start Address	Practice Location

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