Individual
MATILDE MASSANA STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1707 N MOUNT AUBURN RD, SUITE K, CAPE GIRARDEAU, MO 63701-2169
(573) 335-0570
(573) 335-8559
Mailing address
1707 N MOUNT AUBURN RD, SUITE K, CAPE GIRARDEAU, MO 63701-2169
(573) 335-0570
(573) 335-8559
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000686
MO
1041C0700X
Clinical Social Worker
149.006232
IL
1041C0700X
Clinical Social Worker
SW 5084
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22405
BLUE CROSS BLUE SHIELD
MO
05
—
498251701
—
MO
Enumeration date
11/24/2006
Last updated
07/08/2007
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