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Individual

MRS. MARGARET ANNE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR LMT

Contact information

Practice address
1012 UNION ST, BANGOR, ME 04401-0000
(207) 945-5247
(207) 947-0435
Mailing address
1048 UNION ST, SUITE 5, BANGOR, ME 04401-0000
(207) 945-5247
(207) 947-0435

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MT2661
ME
225X00000X
Occupational Therapist
Primary
OT307
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT307
ME LICENSE
ME
Enumeration date
07/17/2006
Last updated
12/19/2007
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