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General NPI Number Information
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NPI Number | 1891975397
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Entity Type | Individual
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Provider Name | DAWN M STEWART MS, BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 214 S GREER ST
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City | MEMPHIS
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State | TN
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Zip | 38111-3434
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Country | US
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Telephone | 901-849-6433
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Fax |
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Provider Business Mailing Address
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Address Line | 214 S GREER ST
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City | MEMPHIS
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State | TN
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Zip | 38111-3434
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Country | US
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Telephone | 901-849-6433
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | BCBA #: 1-07-3269
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0000000078
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License Number State | TN
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