Healthcare Provider Details

I. General information

NPI: 1619390895
Provider Name (Legal Business Name): BRYANNE LOVELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 E MAIN ST
DOVER FOXCROFT ME
04426-1323
US

IV. Provider business mailing address

94 WATER ST
GUILFORD ME
04443-6338
US

V. Phone/Fax

Practice location:
  • Phone: 207-604-8434
  • Fax: 844-310-0239
Mailing address:
  • Phone: 207-604-8434
  • Fax: 844-310-0239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT3007
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: