Individual
CRYSTAL ELIZABETH DESJARDINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 CAMPUS AVENUE, LEWISTON, ME 04240
(207) 777-4200
Mailing address
12 GROVEMOUNT LANE, LEWISTON, ME 04240-4519
(207) 786-5511
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1690
ME
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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