Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 6277 | NC |
NPI | 1881087237 |
---|---|
Provider Name | Susan Iris Stone |
First Address | Apex, NC 27539-4107 |
Second Address | Apex, NC 27539-4107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2015 |
Last Update Date | 10/03/2015 |