Provider Demographics
NPI:1851364095
Name:STEWART, VACARRI MONIQUE (OTR)
Entity Type:Individual
Prefix:MISS
First Name:VACARRI
Middle Name:MONIQUE
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 1:8534 W MILL RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-1934
Mailing Address - Country:US
Mailing Address - Phone:414-353-2300
Mailing Address - Fax:414-353-2727
Practice Address - Street 1:8619 S HOWELL AVE
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-2919
Practice Address - Country:US
Practice Address - Phone:414-856-1888
Practice Address - Fax:414-727-5779
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2339026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist