Individual
SYDNEY SHANEL STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9942 SVL BOX, VICTORVILLE, CA 92395-5144
(909) 413-1561
Mailing address
9942 SVL BOX, VICTORVILLE, CA 92395-5144
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106E00000X
Assistant Behavior Analyst
Primary
1114356797
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114356797
—
CA
Enumeration date
11/05/2013
Last updated
11/12/2018
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