Healthcare Provider Details

I. General information

NPI: 1902304918
Provider Name (Legal Business Name): ASHLEY MERCIER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PRESUMPSCOT ST
PORTLAND ME
04103-5225
US

IV. Provider business mailing address

148 LYONS POINT RD
RAYMOND ME
04071-5515
US

V. Phone/Fax

Practice location:
  • Phone: 207-699-5531
  • Fax:
Mailing address:
  • Phone: 603-321-4781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2727
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT3406
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: