Individual
SUSAN E. GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
65 DROWN LN, LYMAN, ME 04002-6027
(207) 985-0374
(207) 985-7937
Mailing address
65 DROWN LN, LYMAN, ME 04002-6027
(207) 985-0374
(207) 985-7937
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT79
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12300642
CAQH
ME
Enumeration date
06/14/2012
Last updated
06/14/2012
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