Individual
KIMBERLY STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
139 TODDY HILL RD, SANDY HOOK, CT 06482-1362
(203) 364-3125
Mailing address
139 TODDY HILL RD, SANDY HOOK, CT 06482-1362
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002517
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629061304
OTHER
CT
Enumeration date
09/15/2017
Last updated
09/15/2017
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