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Individual

DR. KEN J STONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSY D

Contact information

Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 461-5600
(701) 461-5649
Mailing address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 461-5600
(701) 461-5649

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
ND 244
ND
103TP0814X
Psychoanalysis Psychologist
Primary
244
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
026767
BCBS OF ND PIN
ND
05
084314800
MN
01
13475
BSBS OF MN PIN
MN
Enumeration date
07/10/2006
Last updated
01/07/2008
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