Provider Demographics
NPI:1053022376
Name:STONER, ABIGAIL NICOLE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:NICOLE
Last Name:STONER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15610 KAYLA LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-3229
Mailing Address - Country:US
Mailing Address - Phone:240-382-9004
Mailing Address - Fax:
Practice Address - Street 1:4640 WEDGEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-7114
Practice Address - Country:US
Practice Address - Phone:240-457-9558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA03095224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant