Healthcare Provider Details

I. General information

NPI: 1720982036
Provider Name (Legal Business Name): DEANNA HUTNIK-RAIHL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 TENNEY HILL RD
CASCO ME
04015-3404
US

IV. Provider business mailing address

131 TENNEY HILL RD
CASCO ME
04015-3404
US

V. Phone/Fax

Practice location:
  • Phone: 207-344-4437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLMT4959
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: