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Individual

MRS. LAUREN IVA-BENNETT WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
175 PORTLAND RD, BRIDGTON, ME 04009-4254
(207) 777-7740
Mailing address
656 VERNON ST, BETHEL, ME 04217-7006
(207) 754-2496

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3816
225X00000X
Occupational Therapist

Other

Enumeration date
11/16/2020
Last updated
04/05/2024
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