Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OT1716 | ME |
NPI | 1477984755 |
---|---|
Provider Name | Jamey Roy Cotnoir |
First Address | Monmouth, ME 04259-0115 |
Second Address | Monmouth, ME 04259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2013 |
Last Update Date | 11/12/2013 |