Individual
STACY T STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1931 MOTT AVE, FAR ROCKAWAY, NY 11691-4100
(718) 471-6818
Mailing address
1931 MOTT AVE, FAR ROCKAWAY, NY 11691-4100
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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