Individual
PENNY LYNN STONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 N FAIRLAND ST, PRYOR, OK 74361-4203
(918) 825-1405
(918) 825-1406
Mailing address
109 N FAIRLAND ST, PRYOR, OK 74361-4203
(918) 825-1405
(918) 825-1406
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/25/2018
Last updated
12/18/2019
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