Individual
BRANDON TAYLOR STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
2149 N FREEWATER AVE, BOISE, ID 83713-6628
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
20043535A
IN
103G00000X
Clinical Neuropsychologist
Primary
PSY-203695
ID
103T00000X
Psychologist
PSY-203695
ID
Other
Enumeration date
04/08/2022
Last updated
04/24/2026
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