Provider Demographics
NPI:1043097033
Name:STONE, ADRIANNA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4703 BIRCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALGER
Mailing Address - State:MI
Mailing Address - Zip Code:48610-9533
Mailing Address - Country:US
Mailing Address - Phone:989-859-6447
Mailing Address - Fax:
Practice Address - Street 1:607 W AVENUE B
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-1553
Practice Address - Country:US
Practice Address - Phone:254-547-1033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119538235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist