Provider Demographics
NPI:1225387731
Name:STONE, SUSAN DAWN
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:DAWN
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 1:88 ROCKY DR
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-9538
Mailing Address - Country:US
Mailing Address - Phone:972-938-7705
Mailing Address - Fax:972-938-7705
Practice Address - Street 1:88 ROCKY DR
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75167-9538
Practice Address - Country:US
Practice Address - Phone:972-938-7705
Practice Address - Fax:972-938-7705
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator