Organization
BUILDING BLOCKS PEDIATRIC THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY ANN DICKSON OTR/L (PRESIDENT)
(207) 216-3410
Entity
Organization
Contact information
Practice address
4 MOUNTAIN RD, SOUTH BERWICK, ME 03908-2149
(207) 216-3410
(207) 384-5845
Mailing address
4 MOUNTAIN RD, SOUTH BERWICK, ME 03908-2149
(207) 216-3410
(207) 384-5845
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT637
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0470761
CIGNA
—
05
—
172880000
—
ME
Enumeration date
03/16/2009
Last updated
03/16/2009
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