Provider Demographics
NPI:1689714644
Name:STONEMAN, KATHLEEN VICTORIA (BS, MSOM, CAC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:VICTORIA
Last Name:STONEMAN
Suffix:
Gender:F
Credentials:BS, MSOM, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 TAYLOR AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-2837
Mailing Address - Country:US
Mailing Address - Phone:262-744-0906
Mailing Address - Fax:
Practice Address - Street 1:600 WILLIAMSON STREET
Practice Address - Street 2:SUITE 7
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703
Practice Address - Country:US
Practice Address - Phone:608-441-9355
Practice Address - Fax:608-441-9353
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI503-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist