Individual
TINA MARIE WILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
12 SPRUCE ST, AUGUSTA, ME 04330-5204
(207) 624-2485
Mailing address
225 MORRILL RD, WINSLOW, ME 04901-0031
(207) 872-5654
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA2806
ME
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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