Doctor Name: | KRISTIN STEWART |
NPI Number: | 1033595079 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2015026811 |
Business Practice Address: | 902 Edmond St Suite 203 Saint Joseph, MO - 645012749 |
Business Phone Number: | 8163644300 |
Business Fax Number: | |
Mailing Address: | 902 Edmond St, Suite 203 SAINT JOSEPH |
State: | MO |
Postal Code: | 645012749 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/31/2015 |
NPI Last Update Date: | 07/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2015026811 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |