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General NPI Number Information
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NPI Number | 1932924214
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Entity Type | Individual
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Provider Name | KIMBERLY NAOMI STEWART OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 4200 MORGANTON RD STE 207
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-1564
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Country | US
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Telephone | 910-748-0009
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Fax |
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Provider Business Mailing Address
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Address Line | 512 SCOTIA LN APT C
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-4805
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Country | US
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Telephone | 910-753-5741
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 17325
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License Number State | NC
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