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Individual

DONNA LEE CASAVANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11 ICHABOD LN, HAMPDEN, ME 04444-2004
(207) 862-5184
Mailing address
11 ICHABOD LN, HAMPDEN, ME 04444-2004
(207) 862-5184

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
198710000
ME
Enumeration date
04/16/2009
Last updated
04/16/2009
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