| NPI | 1619164407 |
|---|---|
| Former Name | NICOLE THERESE STEWARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW60091324) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904006506) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2014-10-20 |