Provider Demographics
NPI:1386022473
Name:STONE, HEATHER L (AUD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:STONE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E. SUNSET ROAD
Mailing Address - Street 2:UNIT 96595
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-1246
Mailing Address - Country:US
Mailing Address - Phone:702-798-0113
Mailing Address - Fax:866-291-5242
Practice Address - Street 1:1320 OLD CHAIN BRIDGE RD
Practice Address - Street 2:STE 185
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3956
Practice Address - Country:US
Practice Address - Phone:703-942-8110
Practice Address - Fax:703-942-8042
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001584231H00000X
PAAT006391231H00000X
VA2101002165237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist