Provider Demographics
NPI:1689797896
Name:STEWART, DEBBIE J
Entity Type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:J
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8801 LIBERTY DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5172
Mailing Address - Country:US
Mailing Address - Phone:505-858-3112
Mailing Address - Fax:
Practice Address - Street 1:2936 HUGHES RD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-5509
Practice Address - Country:US
Practice Address - Phone:505-873-8512
Practice Address - Fax:505-873-8513
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1206225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist