Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0701006485 | VA |
NPI | 1003249350 |
---|---|
Provider Name | Ms. Susan Leigh Stone |
First Address | Fredericksburg, VA 22401-5719 |
Second Address | King George, VA 22485-3408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2013 |
Last Update Date | 10/02/2016 |