Individual
SOPHIA DESJARDINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
234 NORTHEAST RD, STANDISH, ME 04084-6495
(800) 743-6802
Mailing address
603 PREBLE ST, APT. 1S, CAPE ELIZABETH, ME 04107-1032
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA3187
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
ME
Enumeration date
12/27/2016
Last updated
12/27/2016
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