Individual
KAYLI-SUSAN MAREAN LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 COLLEGE ST, LEWISTON, ME 04240-2424
(207) 795-4195
Mailing address
PO BOX 872, STANDISH, ME 04084-0872
(207) 671-0105
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4264
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OT4264
—
ME
Enumeration date
04/27/2022
Last updated
04/27/2022
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