Doctor Name: | MR. NATHAN WADE STEWARD |
NPI Number: | 1043675945 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LACE |
License Number: | 4942 |
Business Practice Address: | 926 8th Ave North Great Falls, MT - 59401 |
Business Phone Number: | 4068990122 |
Business Fax Number: | |
Mailing Address: | 926 8th Ave North, GREAT FALLS |
State: | MT |
Postal Code: | 59401 |
Phone Number: | 4068990122 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2015 |
NPI Last Update Date: | 12/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 4942 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |