Individual
MS. EILEEN FAYE BROBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
68 PINEWOOD DR, AUBURN, ME 04210-9205
(207) 784-6076
Mailing address
68 PINEWOOD DR, AUBURN, ME 04210-9205
(207) 784-6076
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT509
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225X00000X
OCCUPATIONAL THERAPIST
ME
Enumeration date
03/16/2007
Last updated
07/08/2007
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