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Individual

MS. TERESA JO STUART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LSCSW, LCAC

Contact information

Practice address
100 MILITARY AVE, SUITE 116, DODGE CITY, KS 67801-4946
(620) 338-2168
(620) 225-1311
Mailing address
PO BOX 602, BUCKLIN, KS 67834-0602
(620) 338-2168
(620) 225-1311

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAC 186
KS
1041C0700X
Clinical Social Worker
Primary
LSCSW 2135
KS

Other

Enumeration date
08/20/2006
Last updated
04/27/2012
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