Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner | 00003927 | |
N | 225C00000X | Rehabilitation Counselor | 00003927 |
NPI | 1205275393 |
---|---|
Provider Name | Stephen C Crate |
First Address | Augusta, ME 04330-6657 |
Second Address | Augusta, ME 04330-6657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2013 |
Last Update Date | 23/01/2014 |