Healthcare Provider Details

I. General information

NPI: 1437770252
Provider Name (Legal Business Name): THE O.T. SPOT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 MAIN ST.
MILBRIDGE ME
04658
US

IV. Provider business mailing address

235 N MAIN ST
MILBRIDGE ME
04658-3413
US

V. Phone/Fax

Practice location:
  • Phone: 207-546-2880
  • Fax: 207-536-2326
Mailing address:
  • Phone: 207-546-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CASSANDRA LYNN OPENSHAW
Title or Position: OWNER
Credential:
Phone: 207-546-0723