MEDICARE: KE'AIRA STEWART

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1194459602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KE'AIRA STEWART

Provider Business Mailing Address
First Line	:	2726 BELOIT DR
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-1731
Country	:	US
Telephone Number	:	314-601-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	2726 BELOIT DR
Second Line	:
City	:	MARYLAND HEIGHTS
State	:	MO
Zip	:	63043-1731
Country	:	US
Telephone Number	:	314-601-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2022
Last Update Date	:	07/11/2022

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