Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT56 | ME |
NPI | 1003121161 |
---|---|
Provider Name | Anne Marie Sirois |
First Address | Saco, ME 04072-2812 |
Second Address | Saco, ME 04072-2812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2010 |
Last Update Date | 13/08/2010 |