Provider Demographics
NPI:1710619424
Name:STONE, CATHERINE (CMT, LMT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:CMT, LMT
Other - Prefix:
Other - First Name:CATE
Other - Middle Name:
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:51 CHANNEL RD
Mailing Address - Street 2:
Mailing Address - City:TINMOUTH
Mailing Address - State:VT
Mailing Address - Zip Code:05773-1100
Mailing Address - Country:US
Mailing Address - Phone:915-240-1862
Mailing Address - Fax:
Practice Address - Street 1:51 CHANNEL RD
Practice Address - Street 2:
Practice Address - City:TINMOUTH
Practice Address - State:VT
Practice Address - Zip Code:05773-1100
Practice Address - Country:US
Practice Address - Phone:915-240-1862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT164.0001032225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1452202OtherABMP