Healthcare Provider Details

I. General information

NPI: 1447089644
Provider Name (Legal Business Name): AISLINN STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11024 N 28TH DR STE 110A
PHOENIX AZ
85029-4378
US

IV. Provider business mailing address

13794 W WADDELL RD STE 203
SURPRISE AZ
85379-8499
US

V. Phone/Fax

Practice location:
  • Phone: 877-634-7333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC23252
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: