Individual
TANYA DEANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 CAMPUS AVE, LEWISTON, ME 04240-6019
(207) 777-4219
Mailing address
8 CROSSRIDGE DR, WINDHAM, ME 04062-5846
(207) 890-8623
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2996
ME
Other
Enumeration date
11/22/2019
Last updated
11/22/2019
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