Provider Demographics
NPI:1760237671
Name:STEWART, SYDNEY MORGAN
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:MORGAN
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 W 1ST ST UNIT 451
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-5359
Mailing Address - Country:US
Mailing Address - Phone:309-973-6359
Mailing Address - Fax:
Practice Address - Street 1:501 W 1ST ST UNIT 451
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5359
Practice Address - Country:US
Practice Address - Phone:309-973-6359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician