Individual
BETH M WOODBREY-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
281 BURLEIGH RD, BANGOR, ME 04401-2511
(207) 262-7173
(207) 947-2465
Mailing address
PO BOX 835, BANGOR, ME 04402-0835
(207) 262-7173
(207) 947-2465
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT219
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202200099
—
ME
Enumeration date
12/18/2006
Last updated
01/28/2011
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