Individual
STACEY WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
15 PIPER RD, SCARBOROUGH, ME 04074-7575
(207) 883-8700
Mailing address
702 OCEAN AVE APT 1, PORTLAND, ME 04103-2799
(860) 490-0318
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
004002
CT
225XG0600X
Gerontology Occupational Therapist
Primary
OT4253
ME
Other
Enumeration date
09/08/2014
Last updated
06/06/2022
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