Individual
JANE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
196 ALLEN AVE, PORTLAND, ME 04103-3711
(207) 874-8133
Mailing address
196 ALLEN AVE, PORTLAND, ME 04103-3711
(207) 874-8133
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT43
ME
Other
Enumeration date
09/03/2010
Last updated
09/03/2010
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