Provider Demographics
NPI:1215724778
Name:HADDOCK-STEWART, DANYA
Entity type:Individual
Prefix:
First Name:DANYA
Middle Name:
Last Name:HADDOCK-STEWART
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 E 510 RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74019-5659
Mailing Address - Country:US
Mailing Address - Phone:360-632-9440
Mailing Address - Fax:
Practice Address - Street 1:12600 E 510 RD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74019-5659
Practice Address - Country:US
Practice Address - Phone:360-632-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist