Doctor Name: | JENNIFER STEWART |
NPI Number: | 1376888081 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 3769154 |
Business Practice Address: | 1100 Commerce Dr Suite 114 Mount Pleasant, WI - 534063700 |
Business Phone Number: | 2628863431 |
Business Fax Number: | 2628863954 |
Mailing Address: | 1100 Commerce Dr, Suite 114 MOUNT PLEASANT |
State: | WI |
Postal Code: | 534063700 |
Phone Number: | 2628863431 |
Fax Number: | 2628863954 |
NPI Enumeration Date: | 12/06/2012 |
NPI Last Update Date: | 12/06/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3769154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |