Individual
JENESSA FISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
94 MAIN ST, BUXTON, ME 04093
(207) 929-3831
Mailing address
58 FEDERAL ST, APT 1, PORTLAND, ME 04101
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2561
ME
225X00000X
Occupational Therapist
TT60155766
WA
Other
Enumeration date
05/23/2011
Last updated
03/24/2014
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