Provider Demographics
NPI:1982092391
Name:STONER, MONICA (OT)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:STONER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-2521
Mailing Address - Country:US
Mailing Address - Phone:850-769-5371
Mailing Address - Fax:850-872-9558
Practice Address - Street 1:927 GRACE AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2521
Practice Address - Country:US
Practice Address - Phone:850-769-5371
Practice Address - Fax:850-872-9558
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2767222Q00000X
FLOT16570225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR205480721Medicaid