Individual
THOMAS STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 LASER RD NE, RIO RANCHO, NM 87124-4517
(505) 896-0667
Mailing address
500 LASER RD NE, RIO RANCHO, NM 87124-4517
(505) 896-0667
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
227649
NM
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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