| NPI | 1740938448 |
|---|---|
| Former Legal Business Name | KRISTEN STEWART |
| Entity Type | Organization |
| Authorized Contact | KRISTEN K STEWART Occupational Therapist 315-408-1337 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-03-13 |
| Last Update Date | 2022-03-13 |