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Individual

MOLLY ANNA NORTHWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
72 STRAWBERRY AVE, LEWISTON, ME 04240-5952
(207) 782-2150
Mailing address
72 STRAWBERRY AVE, LEWISTON, ME 04240-5952
(207) 782-2150

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
TO2685
ME

Other

Enumeration date
11/05/2012
Last updated
11/05/2012
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