Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT1518 | ME |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT1518 | ME |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT1518 | ME |
N | 225XP0200X | Occupational Therapist - Pediatrics | OT1518 | ME |
NPI | 1649943382 |
---|---|
Provider Name | Wendy Skahan |
First Address | Sanford, ME 04073-3062 |
Second Address | Sanford, ME 04073-3062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2021 |
Last Update Date | 26/08/2021 |