Individual
ERIKA MACDONALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
850 BAXTER BLVD, PORTLAND, ME 04103-4901
(207) 774-7878
Mailing address
6 WINTERGREEN DR, GORHAM, ME 04038-1531
(207) 712-5133
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2856
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT2856
OT LICENSE
ME
Enumeration date
03/27/2018
Last updated
03/27/2018
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