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Individual

MARTINA STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2301 W DUNLAP AVE STE 204, PHOENIX, AZ 85021-2846
(202) 294-0315
Mailing address
1831 E APACHE BLVD APT 2098, TEMPE, AZ 85281-6682

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
106S00000X
Behavior Technician
Primary

Other

Enumeration date
11/02/2022
Last updated
11/02/2022
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