Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT1438 | ME |
NPI | 1548597271 |
---|---|
Provider Name | Katherine Hersey |
First Address | Saco, ME 04072-3180 |
Second Address | Saco, ME 04072-3180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2009 |
Last Update Date | 18/11/2009 |