Individual
JESSICA LYNNE STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
15 STRAWBERRY AVE, LEWISTON, ME 04240-5941
(207) 330-9236
Mailing address
11 HATCH RD, LISBON, ME 04250-6211
(207) 240-2355
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT1788
ME
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418120099
—
ME
Enumeration date
09/15/2006
Last updated
12/15/2024
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