Individual
TYESHA RAKAYLEN STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20400 COLONEL GLENN RD, LITTLE ROCK, AR 72210-5323
(501) 851-5000
Mailing address
20400 COLONEL GLENN RD, LITTLE ROCK, AR 72210-5323
(501) 851-5000
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
2557
AR
Other
Enumeration date
09/07/2019
Last updated
09/07/2019
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