Individual
KRISTEN CUSHMAN INMAN
Active
Individual
KRISTEN CUSHMAN INMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT1037
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061495
ANTHEM PROVIDER NUMBER
ME
01
—
237-4358
AETNA PROVIDER NUMBER
ME
Enumeration date
07/30/2006
Last updated
07/09/2007
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