Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT2503 | ME |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT2503 | ME |
NPI | 1174891493 |
---|---|
Provider Name | Leah Michelle Hughes |
First Address | Old Town, ME 04468-1121 |
Second Address | Brewer, ME 04412-1628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 01/12/2011 |