Provider Demographics
NPI:1316063449
Name:STEWART, MARGUERITE (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARGUERITE
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 101062
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-1062
Mailing Address - Country:US
Mailing Address - Phone:303-778-9989
Mailing Address - Fax:303-871-0992
Practice Address - Street 1:3955 E EXPOSITION AVE
Practice Address - Street 2:# 408
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5000
Practice Address - Country:US
Practice Address - Phone:303-778-9989
Practice Address - Fax:303-871-0992
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1641103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07016413Medicaid
CO07016413Medicaid