Individual
BONNIE MARIE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
200 N 7TH AVE, STURGEON BAY, WI 54235-1708
(920) 743-6274
Mailing address
1193 DOUSMAN ST, GREEN BAY, WI 54303-3054
(920) 619-4072
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4111-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40881000
—
WI
Enumeration date
04/03/2008
Last updated
04/03/2008
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