Individual
INDIA L STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LNT, CMP
Contact information
Practice address
5205 HARDY CT, RAYTOWN, MO 64133-7924
(404) 707-1628
Mailing address
5205 HARDY CT, RAYTOWN, MO 64133-7924
(404) 707-1628
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
NT021360
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NT021360
GA STATE BOARD OF PROFESSIONAL LICENSING
GA
Enumeration date
01/04/2022
Last updated
12/10/2024
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