Healthcare Provider Details

I. General information

NPI: 1356194237
Provider Name (Legal Business Name): SYDNEY VIOLET STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7880 W GREENWAY RD
PEORIA AZ
85381-3830
US

IV. Provider business mailing address

7700 W ASPERA BLVD APT 3034
GLENDALE AZ
85308-7930
US

V. Phone/Fax

Practice location:
  • Phone: 623-412-5075
  • Fax:
Mailing address:
  • Phone: 903-617-4194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: