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General NPI Number Information
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NPI Number | 1619457793
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Entity Type | Individual
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Provider Name | SKYLAR STEWART
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Gender | Female
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Dates
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Enumeration Date | 08/17/2018
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 1200 E STAN SCHLUETER LOOP STE 107
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City | KILLEEN
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State | TX
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Zip | 76542-5482
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Country | US
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Telephone | 254-833-5311
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Fax |
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Provider Business Mailing Address
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Address Line | 6248 ASSEMBLY PARK BLVD APT 1148
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City | PLANO
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State | TX
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Zip | 75074-2518
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Country | US
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Telephone | 254-338-4532
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 17271
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License Number State | TX
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