Individual
ANN M ALTAVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1663
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022858
BC/BS
ME
01
—
1265419675
HPHC
ME
05
—
1265419675
—
ME
01
—
3708377
AETNA
ME
Enumeration date
12/28/2005
Last updated
06/30/2024
Update your record
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