Provider Demographics
NPI:1821204066
Name:STEWART, DAWN MICHELE (OTL)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MICHELE
Last Name:STEWART
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38314 BEACHVIEW CT
Mailing Address - Street 2:UNIT 1080
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-2832
Mailing Address - Country:US
Mailing Address - Phone:302-841-8419
Mailing Address - Fax:
Practice Address - Street 1:38314 BEACHVIEW CT
Practice Address - Street 2:UNIT 1080
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-2832
Practice Address - Country:US
Practice Address - Phone:302-841-8419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0000014225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist