Healthcare Provider Details

I. General information

NPI: 1265350581
Provider Name (Legal Business Name): SKYLAR MAY MANYAK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40B #23 NORRE GADE
ST. THOMAS VI
00802
US

IV. Provider business mailing address

38 HILLTOP DR
DOUGLAS MA
01516-2576
US

V. Phone/Fax

Practice location:
  • Phone: 207-671-9475
  • Fax:
Mailing address:
  • Phone: 508-341-2537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTL36729
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: