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General NPI Number Information
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NPI Number | 1417827882
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Entity Type | Organization
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Legal Business Name | SPROUT & SOAR THERAPY LLC
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 1 CUMBERLAND PL STE 122
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City | BANGOR
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State | ME
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Zip | 04401-5090
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Country | US
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Telephone | 207-300-4321
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Fax | 844-520-1784
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Provider Business Mailing Address
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Address Line | 575 PATTEN DR
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City | HERMON
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State | ME
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Zip | 04401-0917
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Country | US
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Telephone | 207-300-4321
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Fax | 844-520-1784
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | ERIN HATCH
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Credential | OTR/L
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Telephone | 207-356-5551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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