Individual
JILL E WATROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L
Contact information
Practice address
31 SPURWINK DROVE, CHELSEA, ME 04330
(207) 582-7686
(207) 582-7688
Mailing address
899 RIVERSIDE ST, PORTLAND, ME 04103-1070
(207) 871-1200
(207) 871-1232
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA1921
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1035714
NATIONAL OT LICENSE
—
Enumeration date
10/24/2006
Last updated
07/08/2007
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