Individual
TRACY POMERLEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
207 E MAIN ST, DOVER FOXCROFT, ME 04426-1246
(207) 343-1084
Mailing address
207 E MAIN ST, DOVER FOXCROFT, ME 04426-1246
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA3904
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OA3904
—
ME
Enumeration date
07/12/2022
Last updated
07/12/2022
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