Provider Demographics
NPI:1922682806
Name:STONER, SYDNEY MARIE
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:MARIE
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 1:15012 WYCLIFFE DR APT 27
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-4307
Mailing Address - Country:US
Mailing Address - Phone:308-390-7661
Mailing Address - Fax:
Practice Address - Street 1:8922 CUMING ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2732
Practice Address - Country:US
Practice Address - Phone:402-926-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-21-165425OtherBACB