Provider Demographics
NPI:1750824942
Name:STONE, TAMARA MICHELLE (BSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:MICHELLE
Last Name:STONE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CAVALIER BLVD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-3950
Mailing Address - Country:US
Mailing Address - Phone:859-594-4510
Mailing Address - Fax:859-594-4519
Practice Address - Street 1:75 CAVALIER BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3950
Practice Address - Country:US
Practice Address - Phone:859-594-4510
Practice Address - Fax:859-594-4519
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker