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General NPI Number Information
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NPI Number | 1699664888
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Entity Type | Individual
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Provider Name | SHILOH RAE YAKE
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Gender | Female
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 23 CEDAR RIDGE DR
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City | SKOWHEGAN
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State | ME
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Zip | 04976-4160
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Country | US
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Telephone | 207-474-9686
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Fax |
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Provider Business Mailing Address
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Address Line | 23 CEDAR RIDGE DR
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City | SKOWHEGAN
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State | ME
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Zip | 04976
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Country | US
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Telephone | 802-236-7749
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | TA4835
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 073.0900335
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License Number State | VT
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