Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 8982 | CA |
NPI | 1003456674 |
---|---|
Provider Name | Kaitlyn Frances Stewart |
First Address | Los Angeles, CA 90008-1821 |
Second Address | Los Angeles, CA 90008-1821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2020 |
Last Update Date | 15/01/2020 |