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General NPI Number Information
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NPI Number | 1336911056
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Entity Type | Organization
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Legal Business Name | MEGAN STEWART
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 13473 MOSSY CYPRESS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32223-5021
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Country | US
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Telephone | 904-553-5179
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Fax | 844-464-1063
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Provider Business Mailing Address
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Address Line | 13473 MOSSY CYPRESS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32223-5021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MEGAN STEWART
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Credential |
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Telephone | 904-553-5179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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