Individual
MARY A STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
503 CONSTITUTION DR, IUKA, MS 38852-8605
(662) 424-9500
Mailing address
503 CONSTITUTION DR, IUKA, MS 38852-8605
(662) 424-9500
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-3891
MS
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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