Provider Demographics
NPI:1417663501
Name:STEWART, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 BENNIE ALBRITTON RD
Mailing Address - Street 2:
Mailing Address - City:HOOKERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28538-7157
Mailing Address - Country:US
Mailing Address - Phone:252-320-1869
Mailing Address - Fax:
Practice Address - Street 1:680 BENNIE ALBRITTON RD
Practice Address - Street 2:
Practice Address - City:HOOKERTON
Practice Address - State:NC
Practice Address - Zip Code:28538-7157
Practice Address - Country:US
Practice Address - Phone:252-320-1869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
224Z00000X
NC9718224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant