Individual
JILLIAN R O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
125 PRESUMPSCOT ST, PORTLAND, ME 04103-5225
(207) 699-5531
Mailing address
33 CHARLONATE DR, GRAY, ME 04039-9765
(207) 615-1977
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT1496
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
243990099
—
ME
Enumeration date
09/15/2006
Last updated
08/06/2015
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