MEDICARE: MISS CASEY L TARR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT2600	ME
2	225X00000X	Occupational Therapist	TO2573	ME

General Provider Information

NPI Number	:	1003192188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CASEY L TARR

Provider Business Mailing Address
First Line	:	884 GRIFFIN RIDGE RD
Second Line	:
City	:	MAPLETON
State	:	ME
Zip	:	04757-4149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 BIRD ST
Second Line	:
City	:	HOULTON
State	:	ME
Zip	:	04730-2402
Country	:	US
Telephone Number	:	207-532-6555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2011
Last Update Date	:	01/18/2023

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Directions to “ MISS CASEY L TARR ” Practice Location

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