Provider Demographics
NPI:1710221254
Name:STONE, CAROLYN (NMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 S MILL AVE
Mailing Address - Street 2:SUITE B9
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2153
Mailing Address - Country:US
Mailing Address - Phone:480-331-7353
Mailing Address - Fax:888-533-4283
Practice Address - Street 1:2210 S MILL AVE
Practice Address - Street 2:SUITE B9
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2153
Practice Address - Country:US
Practice Address - Phone:480-331-7353
Practice Address - Fax:888-533-4283
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-1334175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath