Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | OT774 | ME |
NPI | 1033276191 |
---|---|
Provider Name | Wendy L Sawicki |
First Address | Freeport, ME 04032-0143 |
Second Address | Yarmouth, ME 04096-6995 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
033306 | ANTHEM BLUE CROSS (01) | ME |
MN0281 | MEDICAL NETWORK (01) | ME |