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General NPI Number Information
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NPI Number | 1235460734
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Entity Type | Individual
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Provider Name | SALLY ANN MICHAUD MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 325 KENNEDY MEMORIAL DR
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City | WATERVILLE
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State | ME
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Zip | 04901-4517
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Country | US
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Telephone | 207-692-3467
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Fax |
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Provider Business Mailing Address
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Address Line | 223 MUDGET HILL RD
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City | VASSALBORO
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State | ME
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Zip | 04989-4308
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Country | US
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Telephone | 207-445-3922
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT2572
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License Number State | ME
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