Provider Demographics
NPI:1760158711
Name:STEWART, ASHLEY (OTR)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14115 LOVERS LN STE 115
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-4158
Mailing Address - Country:US
Mailing Address - Phone:540-225-1150
Mailing Address - Fax:540-595-3482
Practice Address - Street 1:14115 LOVERS LN STE 115
Practice Address - Street 2:
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-4158
Practice Address - Country:US
Practice Address - Phone:540-225-1150
Practice Address - Fax:540-595-3482
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA225XP0200X
VA0119-009186225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics