Provider Demographics
NPI:1366138265
Name:STEWART, ERIN ELIZABETH (OTR/L)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:STEWART
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 RICKS TRL
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-4328
Mailing Address - Country:US
Mailing Address - Phone:405-642-2108
Mailing Address - Fax:
Practice Address - Street 1:2401 NW 23RD ST STE 2D
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2420
Practice Address - Country:US
Practice Address - Phone:323-940-5355
Practice Address - Fax:427-040-5212
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5783225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist