Provider Demographics
NPI:1063077444
Name:STONE-AGUIRRE, AMBER (MS)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:STONE-AGUIRRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 W EHRINGHAUS ST STE 198
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-4555
Mailing Address - Country:US
Mailing Address - Phone:252-380-1433
Mailing Address - Fax:
Practice Address - Street 1:173 BILLETTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NC
Practice Address - Zip Code:27921-7566
Practice Address - Country:US
Practice Address - Phone:252-380-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-01
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2221106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist