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Individual

NICOLE SUMMERS MACMILLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR/L

Contact information

Practice address
12 SHUMAN AVE STE 16, AUGUSTA, ME 04330-6020
(207) 623-3900
Mailing address
1019 MEMORIAL DR, WINTHROP, ME 04364-3302
(207) 215-1234

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT4138
ME

Other

Enumeration date
06/07/2021
Last updated
08/11/2021
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