Provider Demographics
NPI:1750524401
Name:STEWART, SARA ANNE (MS)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:ANNE
Last Name:STEWART
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:ANNE
Other - Last Name:DICENZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-0030
Mailing Address - Country:US
Mailing Address - Phone:413-644-0104
Mailing Address - Fax:413-644-0274
Practice Address - Street 1:343 MAIN ST.
Practice Address - Street 2:SUITE 101
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230
Practice Address - Country:US
Practice Address - Phone:413-644-0104
Practice Address - Fax:413-644-0274
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist