Individual
JENNA ELIZABETH NORDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
125 PRESUMPSCOT ST, PORTLAND, ME 04103-5225
(207) 699-5531
Mailing address
125 PRESUMPSCOT ST, PORTLAND, ME 04103-5225
(207) 699-5531
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OA2692
ME
Other
Enumeration date
10/15/2012
Last updated
10/15/2012
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