Individual
TIFFANY A WATERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2335 SE PINE ST, PORTLAND, OR 97214-1641
(207) 240-1565
Mailing address
23 PURCHASE ST, ROCKLAND, ME 04841-2731
(207) 240-1565
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
OT-2586
ME
Other
Enumeration date
04/26/2010
Last updated
06/07/2024
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