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NPI Code Detail

MEDICARE: JODI STEWART PSYD, HSPP

MEDICARE:   JODI  STEWART  PSYD, HSPP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20041793IN

General Provider Information

NPI Number : 1730119173
Entity Type Code : Individual
Provider Name (Legal Business Name) : JODI STEWART PSYD, HSPP
Provider Business Mailing Address
First Line : PO BOX 4323
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47804-0323
Country : US
Telephone Number : 812-231-8323
Fax Number : 812-231-8400
Provider Business Practice Location Address
First Line : 431 E MAIN ST
Second Line :
City : BLOOMFIELD
State : IN
Zip : 47424-1460
Country : US
Telephone Number : 812-384-9452
Fax Number : 812-384-9445
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 07/08/2007

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Directions to “ JODI STEWART PSYD, HSPP” Practice Location

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