Healthcare Provider Details

I. General information

NPI: 1497099618
Provider Name (Legal Business Name): SUSANNE JOY STUART N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 GAYE LN
ARLINGTON TX
76012-3106
US

IV. Provider business mailing address

924 GAYE LN
ARLINGTON TX
76012-3106
US

V. Phone/Fax

Practice location:
  • Phone: 817-642-3014
  • Fax:
Mailing address:
  • Phone: 817-642-3014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT001400
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberCOMT6552
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberANMA - NONE
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberANMA (NONE)
License Number StateNV
# 6
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberCT - ( I-ACT)
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberANMA
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: