Individual
ALICIA NICOLE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
12 SHUMAN AVE STE 16, AUGUSTA, ME 04330-6020
(207) 623-3900
Mailing address
40 DENNETT ST, PORTLAND, ME 04102-1532
(603) 867-3910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3338
ME
Other
Enumeration date
04/10/2018
Last updated
04/10/2018
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