Provider Demographics
NPI:1366747990
Name:STEWART, NOELLE JESSICA (PSYD)
Entity type:Individual
Prefix:DR
First Name:NOELLE
Middle Name:JESSICA
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 1:4 PARK PLZ
Mailing Address - Street 2:STE 302A
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1398
Mailing Address - Country:US
Mailing Address - Phone:610-823-7799
Mailing Address - Fax:
Practice Address - Street 1:273 W UWCHLAN AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3361
Practice Address - Country:US
Practice Address - Phone:610-873-4748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-12
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018382103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist