Healthcare Provider Details

I. General information

NPI: 1962295865
Provider Name (Legal Business Name): LAUREN MAE REID
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
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 CHERRY LN
MADBURY NH
03823-7525
US

V. Phone/Fax

Practice location:
  • Phone: 207-337-1058
  • Fax:
Mailing address:
  • Phone: 603-315-0328
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3943
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4836
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: