Provider Demographics
NPI:1700899267
Name:STEWART, ANNA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIE
Last Name:STEWART
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:136 HOMELAND ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1524
Mailing Address - Country:US
Mailing Address - Phone:203-913-8451
Mailing Address - Fax:203-345-7195
Practice Address - Street 1:6 HOLLYHOCK RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4414
Practice Address - Country:US
Practice Address - Phone:203-913-8451
Practice Address - Fax:203-345-7195
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002214103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP32124777OtherOXFORD INSURANCE COMPANY
CT060002214CT02OtherANTHEM BLUE CROSS