Provider Demographics
NPI:1265797880
Name:STONE, ANGELA N (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:N
Last Name:STONE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 MAIN ST
Mailing Address - Street 2:SPECIAL SERVICES - CLAIM CARE
Mailing Address - City:LEADWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63653-1214
Mailing Address - Country:US
Mailing Address - Phone:573-562-7535
Mailing Address - Fax:573-562-7510
Practice Address - Street 1:1124 MAIN ST
Practice Address - Street 2:SPECIAL SERVICES - CLAIM CARE
Practice Address - City:LEADWOOD
Practice Address - State:MO
Practice Address - Zip Code:63653-1214
Practice Address - Country:US
Practice Address - Phone:573-562-7535
Practice Address - Fax:573-562-7510
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005028566235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist