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Organization

WILLOW TREE OCCUPATIONAL THERAPY, LLC

Active
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Organization

WILLOW TREE OCCUPATIONAL THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA BAKER GOULET OTR/L (OCCUPATIONAL THERAPIST)
(207) 659-1453
Entity
Organization

Contact information

Practice address
64 EXETER RD, CORINTH, ME 04427-3050
(207) 659-1453
Mailing address
64 EXETER RD, CORINTH, ME 04427-3050
(207) 659-1453

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154517969
ME
Enumeration date
08/14/2019
Last updated
08/14/2019
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