Individual
CRESCENTIA JEAN FOSMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
79 CAT MOUSAM RD, KENNEBUNK, ME 04043-6924
(207) 985-3030
Mailing address
484 MAIN ST, APT. 102, BIDDEFORD, ME 04005-2137
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
014074
NY
225X00000X
Occupational Therapist
Primary
OT1976
ME
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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