Individual
KIRSTEN (COULTER) LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 PRESUMPSCOT ST, PORTLAND, ME 04103-5225
(207) 828-0754
Mailing address
84 CARLETON ST, APT #21, PORTLAND, ME 04102-3350
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2055
ME
Other
Enumeration date
02/23/2007
Last updated
07/09/2007
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