Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 14-1456 | AZ |
NPI | 1124421037 |
---|---|
Provider Name | Dr. Elaine L. Stewart |
First Address | Phoenix, AZ 85018-3602 |
Second Address | Phoenix, AZ 85018-3602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2014 |
Last Update Date | 06/10/2014 |