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Organization

OUTSIDE THE LINES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TAYLOR ELLEN PRENDERGAST OTR/L (PRINCIPAL PEDIATRIC OT)
(207) 286-6832
Entity
Organization

Contact information

Practice address
100 MAIN ST, SUITE 140, DOVER, NH 03820-3882
(207) 286-6832
(866) 702-2502
Mailing address
PO BOX 1772, DOVER, NH 03821-1772
(207) 286-6832
(866) 702-2502

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
2020
NH

Other

Enumeration date
08/12/2012
Last updated
08/12/2012
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