Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 4005 | WI |
NPI | 1003084526 |
---|---|
Provider Name | Suzanne M Stewart |
First Address | Eau Claire, WI 54702-1510 |
Second Address | Eau Claire, WI 54703-5222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2008 |
Last Update Date | 17/03/2009 |