| NPI | 1669763579 |
|---|---|
| Former Name | WANDA SUE STONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171M00000X Case Manager/Care Coordinator | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2021-02-10 |