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Individual

MR. SHAYNE STONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9120 SPRINGBROOK DR NW, COON RAPIDS, MN 55433
(651) 336-9908
Mailing address
9120 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5845
(651) 336-9908

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
225X00000X
Occupational Therapist
Primary
106986
MN

Other

Enumeration date
07/20/2018
Last updated
01/25/2023
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