Provider Demographics
NPI:1346564622
Name:STEWART, CAMILLE FRANCES (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CAMILLE
Middle Name:FRANCES
Last Name:STEWART
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11801 PIERCE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-4400
Mailing Address - Country:US
Mailing Address - Phone:239-200-3096
Mailing Address - Fax:
Practice Address - Street 1:11801 PIERCE ST STE 200
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-4400
Practice Address - Country:US
Practice Address - Phone:239-200-3096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 4992235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSZ 4992OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH DIVISION: PROVISIONAL SPEECH-LANGUAGE PATH