Individual
JERA LYNN STEWART
Active
Individual
JERA LYNN STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
401
MT
103G00000X
Clinical Neuropsychologist
6301013364
MI
103G00000X
Clinical Neuropsychologist
Primary
PSY-PSY-LIC-401
MT
Other
Enumeration date
08/27/2008
Last updated
04/10/2015
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