Provider Demographics
NPI:1275830903
Name:STONE, STACI LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:LYNN
Last Name:STONE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 PARKVIEW MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4911
Mailing Address - Country:US
Mailing Address - Phone:970-310-1490
Mailing Address - Fax:
Practice Address - Street 1:623 PARKVIEW MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4911
Practice Address - Country:US
Practice Address - Phone:970-310-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1366225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist