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General NPI Number Information
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NPI Number | 1629679774
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Entity Type | Individual
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Provider Name | SHEA LYNN HEWITT OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 36 WORKMAN TER
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City | LINCOLN
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State | ME
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Zip | 04457-1162
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Country | US
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Telephone | 207-794-2173
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Fax |
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Provider Business Mailing Address
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Address Line | 108 CREAMERY RD
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City | OSWEGO
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State | NY
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Zip | 13126-6160
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Country | US
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Telephone | 315-532-9307
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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 | 14610
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT3977
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License Number State | ME
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