Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | TA2895 | ME |
NPI | 1013325836 |
---|---|
Provider Name | Mrs. Elana Nelson |
First Address | Litchfield, ME 04350-4300 |
Second Address | Litchfield, ME 04350-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2014 |
Last Update Date | 27/04/2018 |