Provider Demographics
NPI:1033702212
Name:STONE, ERICA
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2887 W TOWNSHIP ROAD 170
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-9625
Mailing Address - Country:US
Mailing Address - Phone:419-721-1393
Mailing Address - Fax:
Practice Address - Street 1:2887 W TOWNSHIP ROAD 170
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-9625
Practice Address - Country:US
Practice Address - Phone:419-721-1393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child