Individual
MISTY DAWN STUART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
617 SE AVE F, IDABEL, OK 74745-6216
(580) 933-7031
Mailing address
617 SE AVE F, IDABEL, OK 74745-6216
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/06/2012
Last updated
06/27/2014
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