Individual
MARY R DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 661-8030
Mailing address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 661-8030
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000771
CT
225X00000X
Occupational Therapist
OT3937
ME
225XH1200X
Hand Occupational Therapist
OT3937
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT3937
OCCUPATIONAL THERAPY LICENSE
ME
Enumeration date
11/12/2006
Last updated
01/05/2022
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