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General NPI Number Information
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NPI Number | 1841567161
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Entity Type | Individual
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Provider Name | TRICIA-FAE COSSAR LMT, PTA
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Gender | Female
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 116 HAMMOND ST STE 1
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City | BANGOR
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State | ME
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Zip | 04401-4915
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Country | US
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Telephone | 207-416-8820
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Fax |
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Provider Business Mailing Address
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Address Line | 1343 OHIO ST TRLR 8
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City | BANGOR
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State | ME
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Zip | 04401-2718
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Country | US
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Telephone | 207-416-8820
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT6836
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License Number State | ME
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