Doctor Name: | JERA LYNN STEWART |
NPI Number: | 1245487784 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 401 |
Business Practice Address: | 35401 Mission Drive St. Ignatius, MT - 59865 |
Business Phone Number: | 4067453525 |
Business Fax Number: | 4067453529 |
Mailing Address: | P.o. Box 880, ST. IGNATIUS |
State: | MT |
Postal Code: | 59865 |
Phone Number: | 4067453525 |
Fax Number: | 4067453529 |
NPI Enumeration Date: | 08/27/2008 |
NPI Last Update Date: | 04/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 401 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |