Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1003121344 |
---|---|
Provider Name | Ms. Malinda Gayle Stone |
First Address | Poteau, OK 74953 |
Second Address | Poteau, OK 74953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2010 |
Last Update Date | 11/08/2010 |