Individual
BROOKE STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1705 STEVENS AVE, LOUISVILLE, KY 40205-1044
(502) 451-7330
Mailing address
12226 RIDGEMONT RD, LOUISVILLE, KY 40229-4500
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
BOTOTA00218668
KY
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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