Healthcare Provider Details

I. General information

NPI: 1780814020
Provider Name (Legal Business Name): JAMIE HARMON OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 PHEASANT RIDGE DR
WINDHAM ME
04062-4357
US

IV. Provider business mailing address

19 PHEASANT RIDGE DR
WINDHAM ME
04062-4357
US

V. Phone/Fax

Practice location:
  • Phone: 207-838-5575
  • Fax:
Mailing address:
  • Phone: 207-838-5575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT2300
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: