Provider Demographics
NPI:1801038609
Name:STEWART, ZINA BETH (LMT)
Entity Type:Individual
Prefix:MS
First Name:ZINA
Middle Name:BETH
Last Name:STEWART
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ROSEHILL ACRES
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560-9421
Mailing Address - Country:US
Mailing Address - Phone:304-590-0681
Mailing Address - Fax:
Practice Address - Street 1:3534 TEAYS VALLEY RD
Practice Address - Street 2:SUITE 3
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9054
Practice Address - Country:US
Practice Address - Phone:304-397-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1015-4952174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist