Provider Demographics
NPI:1477855419
Name:STEWART, CHERYL L (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:L
Last Name:STEWART
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25636 JAGGER RD
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:51534-6320
Mailing Address - Country:US
Mailing Address - Phone:402-616-9646
Mailing Address - Fax:712-352-2929
Practice Address - Street 1:25636 JAGGER RD
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IA
Practice Address - Zip Code:51534-6320
Practice Address - Country:US
Practice Address - Phone:402-616-9646
Practice Address - Fax:712-352-2929
Is Sole Proprietor?:No
Enumeration Date:2010-11-24
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA597225X00000X
NE366225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist