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General NPI Number Information
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NPI Number | 1821773763
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Entity Type | Organization
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Legal Business Name | DANDELION OCCUPATIONAL THERAPY LLC
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 06/19/2023
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Provider Practice Location Address
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Address Line | 37 GRANITE LEDGE LN
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City | ORRINGTON
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State | ME
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Zip | 04474-3753
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Country | US
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Telephone | 207-991-3064
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 316
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City | ORRINGTON
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State | ME
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Zip | 04474-0316
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Country | US
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Telephone | 207-814-7266
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MICHELLE METTLER
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Credential | MS OTR/L
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Telephone | 207-814-7266
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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 |
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License Number State |
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