# KICKSTART PEDIATRIC THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KICKSTART PEDIATRIC THERAPY, LLC
- **Other names:** Kristen Stewart
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740938448
- **Legal business name:** KICKSTART PEDIATRIC THERAPY, LLC
- **Authorized official:** KRISTEN K STEWART MS, OTR/L (OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (315) 408-1337

## Contact information

- **Practice address:** 185 CRESCENT ST APT 412, WALTHAM, MA 02453-3498
- **Practice address phone:** (315) 408-1337
- **Mailing address:** 185 CRESCENT ST APT 412, WALTHAM, MA 02453-3498
- **Mailing address phone:** (315) 408-1337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2022
- **Last updated:** 03/13/2022