Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT1784 | ME |
NPI | 1316391428 |
---|---|
Provider Name | Rebecca Marie Labrie |
First Address | Ellsworth, ME 04605-1860 |
Second Address | Ellsworth, ME 04605-1860 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2016 |
Last Update Date | 15/04/2016 |