Healthcare Provider Details

I. General information

NPI: 1275420739
Provider Name (Legal Business Name): MISS TESSA ANN STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS TESSA ANN HAIGH

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 PIONEER TRL
CEDAR SPRINGS MI
49319-8136
US

IV. Provider business mailing address

421 PIONEER TRL
CEDAR SPRINGS MI
49319-8136
US

V. Phone/Fax

Practice location:
  • Phone: 616-251-8162
  • Fax: 616-327-4660
Mailing address:
  • Phone: 616-251-8162
  • Fax: 616-327-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: