Healthcare Provider Details

I. General information

NPI: 1740143619
Provider Name (Legal Business Name): MAYA HIXON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 PORTLAND RD STE 10
ARUNDEL ME
04046-8104
US

IV. Provider business mailing address

15 GAY ST APT 1
PORTLAND ME
04103-2416
US

V. Phone/Fax

Practice location:
  • Phone: 207-337-1058
  • Fax:
Mailing address:
  • Phone: 978-809-8734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT4856
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: