Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 1182 | MA |
NPI | 1083042238 |
---|---|
Provider Name | Kathleen Stewart |
First Address | North Reading, MA 01864-2929 |
Second Address | North Reading, MA 01864-2929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2013 |
Last Update Date | 25/10/2013 |