Individual
JESSICA CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
587 RIVERSIDE ST, PORTLAND, ME 04103-1289
(207) 212-4203
Mailing address
2 DAVIS POINT LN, UNIT 1A, CAPE ELIZABETH, ME 04107-2628
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3648
ME
Other
Enumeration date
06/07/2019
Last updated
06/11/2019
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