Individual
MRS. GRETCHEN MICHELLE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
305 AVONDALE CIR, BOSSIER CITY, LA 71112-4272
(318) 549-2815
Mailing address
305 AVONDALE CIR, BOSSIER CITY, LA 71112-4272
(318) 549-2815
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4775
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1478229
—
LA
Enumeration date
03/16/2007
Last updated
07/09/2007
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