Healthcare Provider Details

I. General information

NPI: 1497680342
Provider Name (Legal Business Name): SYDNEY BOYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SPRING ST
WESTBROOK ME
04092-3915
US

IV. Provider business mailing address

300 SPRING ST
WESTBROOK ME
04092-3915
US

V. Phone/Fax

Practice location:
  • Phone: 774-239-5239
  • Fax:
Mailing address:
  • Phone: 774-239-5239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT5014
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: