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General NPI Number Information
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NPI Number | 1760828446
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Entity Type | Individual
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Provider Name | STACY STEWART
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Gender | Female
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Dates
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Enumeration Date | 05/21/2013
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 508 UPLAND ST
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City | KENAI
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State | AK
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Zip | 99611-8026
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Country | US
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Telephone | 907-335-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 716 EVERGREEN FARM DR
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City | TEMPLE
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State | TX
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Zip | 76502-5359
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 112844
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License Number State | TX
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