Individual
MADISON LAUREN LONGFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 SHUMAN AVE STE 16, AUGUSTA, ME 04330-6020
(207) 215-5476
Mailing address
12 SHUMAN AVE STE 16, AUGUSTA, ME 04330-6020
(207) 623-3900
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3248
ME
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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