Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT3735 | ME |
NPI | 1831735836 |
---|---|
Provider Name | Erin Kelly Speeches |
First Address | Gorham, ME 04038-2743 |
Second Address | Lewiston, ME 04240-5935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2019 |
Last Update Date | 09/09/2020 |