Individual
JESICA L. MICHAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
50 DEPOT RD, FALMOUTH, ME 04105-1211
(207) 781-8881
(207) 781-8855
Mailing address
50 DEPOT RD, FALMOUTH, ME 04105-1211
(207) 781-8881
(207) 781-8855
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT2456
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT2456
BOARD OF OCCUPATIONAL THERAPY PRACTICE
ME
Enumeration date
10/08/2010
Last updated
10/08/2010
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