NPI | 1992823728 |
---|---|
Former Name | REATHA L STEWART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 000030121N6 PMHNP-PP) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2007-07-08 |