Doctor Name: | JENNIFER STEWART |
NPI Number: | 1033477120 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 001260 |
Business Practice Address: | 515 E Broadway Council Bluffs, IA - 515034419 |
Business Phone Number: | 7123221407 |
Business Fax Number: | 7123226833 |
Mailing Address: | 1324 N. Lenox Circle, COUNCIL BLUFFS |
State: | IA |
Postal Code: | 51503 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/26/2012 |
NPI Last Update Date: | 05/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 001260 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |