Provider Demographics
NPI:1891279402
Name:STONER, PAULA D
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:D
Last Name:STONER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8624 W STATE ROAD 356
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47138-7616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8624 W STATE ROAD 356
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:IN
Practice Address - Zip Code:47138-7616
Practice Address - Country:US
Practice Address - Phone:812-599-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty