Individual
MARY E ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
86 DURGINTOWN RD, HIRAM, ME 04041-3615
(207) 625-5500
Mailing address
86 DURGINTOWN RD, HIRAM, ME 04041-3615
(207) 625-5500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT576
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100343
ANTHEM
ME
05
—
135630000
—
ME
Enumeration date
07/03/2006
Last updated
10/01/2010
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