Mary Elizabeth Wagstaff
Occupational Therapist - Gerontology
Seaport Village Healthcare 19 General Moore Way
Ellsworth
, Maine 04605
Mary Elizabeth Wagstaff
Occupational Therapist - Gerontology
Seaport Village Healthcare 19 General Moore Way
Ellsworth
, Maine 04605
(207) 266-4396
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About
Features
Specialties
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Mary Elizabeth Wagstaff
- 35 Upland Way
- Ellsworth, ME
- Zip : 04605-3475
- Phone : (207) 266-4396
Second Address
- Mary Elizabeth Wagstaff
- Seaport Village Healthcare 19 General Moore Way
- Ellsworth, ME
- Zip : 04605
- Phone : (207) 667-9336
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XG0600X | Occupational Therapist - Gerontology | OT955 | ME |
National Provider Identifier
| NPI | 1760940464 |
|---|---|
| Provider Name | Mary Elizabeth Wagstaff |
| First Address | Ellsworth, ME 04605-3475 |
| Second Address | Ellsworth, ME 04605 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/03/2019 |
| Last Update Date | 16/04/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.