Provider Demographics
NPI:1952892226
Name:STONE, KATRINA MOORE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:MOORE
Last Name:STONE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:MARIE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7001 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-6719
Mailing Address - Country:US
Mailing Address - Phone:497-476-5352
Mailing Address - Fax:
Practice Address - Street 1:7001 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-6719
Practice Address - Country:US
Practice Address - Phone:407-476-5352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9586103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist