Provider Demographics
NPI:1275789828
Name:STONE, DEADRA L
Entity Type:Individual
Prefix:
First Name:DEADRA
Middle Name:L
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 1:111 APPERSON HTS
Mailing Address - Street 2:
Mailing Address - City:MOUNT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1602
Mailing Address - Country:US
Mailing Address - Phone:859-499-3406
Mailing Address - Fax:859-498-5000
Practice Address - Street 1:111 APPERSON HTS
Practice Address - Street 2:
Practice Address - City:MOUNT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1602
Practice Address - Country:US
Practice Address - Phone:859-499-3406
Practice Address - Fax:859-498-5000
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist