Individual
STEPHANIE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
5148 LOVERS LN, SUITE 2, PORTAGE, MI 49002-1572
(269) 343-3010
(269) 343-3017
Mailing address
5148 LOVERS LN, SUITE 2, PORTAGE, MI 49002-1572
(269) 343-3010
(269) 343-3017
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361002804
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P108927600
BCBSM
MI
Enumeration date
05/12/2006
Last updated
06/11/2020
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