Individual
LILY BRIANNA LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 MOOSEHEAD BLVD, BANGOR, ME 04401-2367
(207) 941-6240
Mailing address
100 MOOSEHEAD BLVD, BANGOR, ME 04401-2367
(207) 941-6240
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4223
ME
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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