Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401007504 | MI |
NPI | 1003410663 |
---|---|
Provider Name | Mrs. Lori Lynn Stone |
First Address | Grand Ledge, MI 48837-9371 |
Second Address | Grand Ledge, MI 48837-9371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2020 |
Last Update Date | 24/11/2020 |