Jackson L Stewart
Psychologist
110 Campus Dr
Bradford
, Pennsylvania 16701-1982
Jackson L Stewart
Psychologist
110 Campus Dr
Bradford
, Pennsylvania 16701-1982
(814) 362-6535
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About
Features
Specialties
- Psychologist
Languages spoken
- English
Location
First Address
- Jackson L Stewart
- 110 Campus Dr
- Bradford, PA
- Zip : 16701-1982
- Phone : (814) 362-6535
Second Address
- Jackson L Stewart
- 110 Campus Dr
- Bradford, PA
- Zip : 16701-1982
- Phone : (814) 362-6535
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 102L00000X | Psychologist | PS004481L | PA |
| Y | 103T00000X | Psychologist | PS004481L | PA |
National Provider Identifier
| NPI | 1003328378 |
|---|---|
| Provider Name | Jackson L Stewart |
| First Address | Bradford, PA 16701-1982 |
| Second Address | Bradford, PA 16701-1982 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/10/2017 |
| Last Update Date | 26/10/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.