Provider Demographics
NPI:1285962407
Name:STUART, ANA LAURA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ANA
Middle Name:LAURA
Last Name:STUART
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 1:50 WATERTOWN ST
Mailing Address - Street 2:#214
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-2542
Mailing Address - Country:US
Mailing Address - Phone:617-512-5759
Mailing Address - Fax:
Practice Address - Street 1:50 WATERTOWN ST
Practice Address - Street 2:#214
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2542
Practice Address - Country:US
Practice Address - Phone:617-512-5759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2099174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist