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Individual

SUSANNE MARTORNAO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14 MURRAY DRIVE, GORHAM, ME 04038
(207) 233-7373
(888) 731-2721
Mailing address
14 MURRAY DRIVE, GORHAM, ME 04038
(207) 233-7373

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1187
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
061223
ANTHEM MAINE
ME
01
1284152
AENTA
ME
05
287920099
ME
Enumeration date
02/14/2007
Last updated
11/21/2012
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