Provider Demographics
NPI:1285479048
Name:STONE, OZELLA RENAE
Entity type:Individual
Prefix:
First Name:OZELLA
Middle Name:RENAE
Last Name:STONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4313 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64130-3045
Mailing Address - Country:US
Mailing Address - Phone:816-799-3355
Mailing Address - Fax:816-599-5969
Practice Address - Street 1:3801 DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64130-2807
Practice Address - Country:US
Practice Address - Phone:816-799-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024010976104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker