Individual
KELLY CASTONGUAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
163 DEERING RIDGE RD, EAST WATERBORO, ME 04030-5312
(207) 459-0927
Mailing address
163 DEERING RIDGE RD, EAST WATERBORO, ME 04030-5312
(207) 459-0927
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT609
ME
Other
Enumeration date
04/28/2018
Last updated
04/28/2018
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