Healthcare Provider Details

I. General information

NPI: 1013138916
Provider Name (Legal Business Name): ANN GRIFFIN CAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 HASSON ST
FARMINGDALE ME
04344-1613
US

IV. Provider business mailing address

15 HASSON ST
FARMINGDALE ME
04344-1613
US

V. Phone/Fax

Practice location:
  • Phone: 207-588-0007
  • Fax:
Mailing address:
  • Phone: 207-588-0007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number278
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: