Individual
JACQUELINE AWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
840 KENNEDY MEMORIAL DR, OAKLAND, ME 04963-4887
(207) 716-1863
Mailing address
840 KENNEDY MEMORIAL DR, OAKLAND, ME 04963-4887
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA3984
ME
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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