Individual
SUSAN LATSHAW JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
959 CONGRESS ST, SUITE 1, PORTLAND, ME 04102-2715
(207) 699-5600
(207) 699-5588
Mailing address
163 SCHOOL ST APT C, BERWICK, ME 03901
(205) 356-2629
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2495
AL
225X00000X
Occupational Therapist
Primary
OT4376
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2495
OT LICENSE
AL
Enumeration date
12/04/2006
Last updated
02/07/2023
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