Individual
POLLY KENISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
42 OAKHURST RD, CAPE ELIZABETH, ME 04107-1421
(207) 615-2096
Mailing address
42 OAKHURST RD, CAPE ELIZABETH, ME 04107-1421
(207) 615-2096
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
344593
ME
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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