Organization
KENNETH L STEWART, PHD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH LYLE STEWART PHD, LP, LMFT (PRESIDENT)
(612) 868-0366
Entity
Organization
Contact information
Practice address
11812 WAYZATA BLVD, SUITE 120, MINNETONKA, MN 55305-2012
(612) 868-0366
Mailing address
3108 HENNEPIN AVE S, MINNEAPOLIS, MN 55408-2619
(612) 868-0366
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2948
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945315600
—
MN
Enumeration date
02/24/2011
Last updated
02/24/2011
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