Provider Demographics
NPI:1083042238
Name:STEWART, KATHLEEN (OTR/L)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-2929
Mailing Address - Country:US
Mailing Address - Phone:978-604-0555
Mailing Address - Fax:
Practice Address - Street 1:13 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-2929
Practice Address - Country:US
Practice Address - Phone:978-604-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-25
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1182225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology