Provider Demographics
NPI:1891110078
Name:STEWART, ALEX MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALEX
Middle Name:MARIE
Last Name:STEWART
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:ALEX
Other - Middle Name:MARIE
Other - Last Name:HINZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 PASO DIABLO ROAD
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667
Mailing Address - Country:US
Mailing Address - Phone:530-728-0757
Mailing Address - Fax:
Practice Address - Street 1:1620 PASO DIABLO RD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-3023
Practice Address - Country:US
Practice Address - Phone:530-728-0757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist