Individual
LAURA NANCY VAILLANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
23 WESTMINSTER ST, LEWISTON, ME 04240-3531
(207) 777-7000
Mailing address
55 WEST ST UNIT 1, FREEPORT, ME 04032-1167
(207) 949-5235
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT3949
ME
Other
Enumeration date
03/21/2021
Last updated
03/21/2021
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