Individual
ANGELA GRONDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
618 MAIN ST, LEWISTON, ME 04240-5935
(207) 795-6110
(207) 795-6189
Mailing address
618 MAIN ST, LEWISTON, ME 04240-5935
(207) 795-6110
(207) 795-6189
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2734
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432355099
—
ME
Enumeration date
04/28/2009
Last updated
02/21/2013
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