=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740143619
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAYA HIXON OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2025
-----------------------------------------------------
Last Update Date | 12/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1222 PORTLAND RD STE 10
-----------------------------------------------------
City | ARUNDEL
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04046-8104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-337-1058
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 GAY ST APT 1
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04103-2416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-809-8734
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OT4856
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------