Individual
LISA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 LAKE ST LOT 1, GEORGETOWN, OH 45121-9309
(513) 313-3548
Mailing address
107 LAKE ST LOT 1, GEORGETOWN, OH 45121-9309
(513) 313-3548
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0801323
—
OH
Enumeration date
09/24/2020
Last updated
09/24/2020
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