Provider Demographics
NPI:1093090813
Name:STUART, ALLISON CHRISTINE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:CHRISTINE
Last Name:STUART
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:CHRISTINE
Other - Last Name:KOTSOVOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1014 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660
Mailing Address - Country:US
Mailing Address - Phone:360-695-1014
Mailing Address - Fax:360-750-1374
Practice Address - Street 1:1014 MAIN STREET
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660
Practice Address - Country:US
Practice Address - Phone:360-695-1014
Practice Address - Fax:360-750-1374
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health