Provider Demographics
NPI:1538596549
Name:STONE, NICOLA (SLP)
Entity type:Individual
Prefix:
First Name:NICOLA
Middle Name:
Last Name:STONE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:NICKI
Other - Middle Name:
Other - Last Name:RUOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7240 ROE AVE
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-2836
Mailing Address - Country:US
Mailing Address - Phone:816-935-4541
Mailing Address - Fax:
Practice Address - Street 1:406 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-3237
Practice Address - Country:US
Practice Address - Phone:979-836-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108287235Z00000X
KS1066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist