| Organization Name: | QUASSAPAUG VENTURES |
| NPI Number: | 1033325089 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHRYN M STEWART (PSYCHOLOGIST) |
| Mailing Address: | 447 N 300 W Suite 7 Kaysville |
| State: | UT US |
| Postal Code: | 840374203 |
| Phone Number: | 8015447413 |
| Fax Number: | 8015443819 |
| NPI Enumeration Date: | 05/15/2007 |
| NPI Last Update Date: | 07/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 369768-2501 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |