Provider Demographics
NPI:1689744302
Name:STEWART STEVENS, EMILY LYNN (MA, LLP)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:LYNN
Last Name:STEWART STEVENS
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:LYNN
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LLP
Mailing Address - Street 1:5877 LARKWOOD CT
Mailing Address - Street 2:APT. 2B
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-6640
Mailing Address - Country:US
Mailing Address - Phone:269-806-9571
Mailing Address - Fax:
Practice Address - Street 1:7920 KIRKLAND CT
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024
Practice Address - Country:US
Practice Address - Phone:269-345-0669
Practice Address - Fax:269-345-5354
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist