Individual
MRS. SHAUNA RENEE BRIMLEY-BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37 POND ST., BANGOR, ME 04401
(207) 945-4334
Mailing address
37 POND ST., BANGOR, ME 04401
(207) 945-4334
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
2503
MA
225XP0200X
Pediatric Occupational Therapist
Primary
OT2623
ME
Other
Enumeration date
11/22/2013
Last updated
02/19/2014
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