Tangela Blackwell-Stoner
Individual provider Active NPI Developmental Therapist · Roxboro, NC
NPI 1336734920 · NPPES record last updated Mar 4, 2021
Key facts
- NPI
- 1336734920
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 166 Quail Creek Dr
Roxboro, NC 27574-6381 - Phone
- (919) 398-3039
- NPI assigned
- Mar 4, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
166 Quail Creek Dr
Roxboro, NC 27574-6381
Mailing address
166 Quail Creek Dr
Roxboro, NC 27574-6381
Phone (919) 398-3039
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All providers in Roxboro, NC · Developmental Therapist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.