Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT1179 | ME |
NPI | 1003893421 |
---|---|
Provider Name | Sheilalee A Fraser |
First Address | Saco, ME 04072-3509 |
Second Address | Saco, ME 04072-3509 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2005 |
Last Update Date | 08/07/2007 |