Provider Demographics
NPI:1326489659
Name:STUART, SHYLA (LMFT)
Entity Type:Individual
Prefix:
First Name:SHYLA
Middle Name:
Last Name:STUART
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 MAIN ST E
Mailing Address - Street 2:SUITE F
Mailing Address - City:BONNEY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:98391-8988
Mailing Address - Country:US
Mailing Address - Phone:253-987-6234
Mailing Address - Fax:
Practice Address - Street 1:8910 MAIN ST E
Practice Address - Street 2:SUITE F
Practice Address - City:BONNEY LAKE
Practice Address - State:WA
Practice Address - Zip Code:98391-8988
Practice Address - Country:US
Practice Address - Phone:253-987-6234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60327726106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist