Doctor Name: | MRS. AMANDA JERRUSIA STUART |
NPI Number: | 1275893851 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LCSWA |
License Number: | 006393 |
Business Practice Address: | 416 W. Ridge St. Rose Hill, NC - 28458 |
Business Phone Number: | 9102892610 |
Business Fax Number: | |
Mailing Address: | 1601 Quarters Landing Cir Apt 602, SNEADS FERRY |
State: | NC |
Postal Code: | 284608318 |
Phone Number: | 7076013387 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2012 |
NPI Last Update Date: | 04/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 006393 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |