Stone, Kelly Russo

Stone, Kelly Russo is an sole proprietor health care provider with primary practice located at 505 Louvois St , Mandeville LA 70448-5468. She recently has 5 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Environmental Modification, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Feeding, Eating & Swallowing, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Mental Health, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurorehabilitation, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Stone, Kelly Russo can be contacted via phone (678) 462-2923.

Contact Information

Primary practice address
505 Louvois St Mandeville LA 70448-5468
Phone: (678) 462-2923
Fax: (866) 753-4652
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Environmental Modification 225XE0001X OTT.Z1156 Louisiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Feeding, Eating & Swallowing 225XF0002X OTT.Z1156 Louisiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Mental Health 225XM0800X OTT.Z1156 Louisiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Neurorehabilitation 225XN1300X OTT.Z1156 Louisiana
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X OTT.Z1156 Louisiana

Profile Details

NPI number 1104053529
LBN Legal business name Stone, Kelly Russo
Credentials OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2009
Last updated Jun 20th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104053529 NPPES
Louisiana MEDICAID 2450514

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