Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6801090751 | MI |
N | 1041C0700X | Clinical Social Worker | 6801090751 | MI |
NPI | 1003134529 |
---|---|
Provider Name | Mrs. Laura Gail Stone |
First Address | Eastpointe, MI 48021-3537 |
Second Address | Detroit, MI 48225-1206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2010 |
Last Update Date | 07/05/2010 |