Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | OT4147 | ME |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT4147 | ME |
NPI | 1609545250 |
---|---|
Provider Name | Miss Rachel Ann Bossi |
First Address | Westbrook, ME 04092-3850 |
Second Address | Westbrook, ME 04092-3850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2021 |
Last Update Date | 05/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
458092 | NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY (01) | |
OT4147 | STATE OF MAINE BOARD OF OCCUPATIONAL THERAPY PRACTICE (01) | ME |