Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2138 | NH |
NPI | 1255676474 |
---|---|
Provider Name | Mrs. Courtney Bryden Guertin |
First Address | Sanford, ME 04073-4221 |
Second Address | Wolfeboro, NH 03894-4222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2012 |
Last Update Date | 28/11/2012 |