Individual
LARISSA BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
959 CONGRESS ST # 1, PORTLAND, ME 04102-2715
(207) 699-5600
Mailing address
959 CONGRESS ST # 1, PORTLAND, ME 04102-2715
(207) 699-5600
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4066
ME
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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