Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 8054 | NC |
NPI | 1235536020 |
---|---|
Provider Name | Katherine Stewart |
First Address | Charlotte, NC 28205-8297 |
Second Address | Concord, NC 28025-2934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2014 |
Last Update Date | 24/11/2014 |