Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 1486 | KS |
NPI | 1134425309 |
---|---|
Provider Name | Mrs. Nicole Elise Stewart |
First Address | Salina, KS 67401-2697 |
Second Address | Salina, KS 67401-2697 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2011 |
Last Update Date | 21/02/2017 |