Individual
TJUANA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
332 WELLS ST APT 108, BRIDGEPORT, CT 06606-5466
(919) 450-6491
Mailing address
332 WELLS STREET #108, BRIDGEPORT, CT 06606
(919) 450-6491
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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