Provider Demographics
NPI:1669957163
Name:POPE-STEWART, JULIE J (DT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:J
Last Name:POPE-STEWART
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-4482
Mailing Address - Country:US
Mailing Address - Phone:773-569-2621
Mailing Address - Fax:
Practice Address - Street 1:4930 KENNEDY AVE
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3729
Practice Address - Country:US
Practice Address - Phone:219-433-9520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist