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NPI Code Detail

MEDICARE: HOLLY ST. ONGE OTR/L

MEDICARE: HOLLY ST. ONGE OTR/L
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
1225XP0200XPediatric Occupational TherapistOT2214ME

General Provider Information

NPI Number : 1245484559
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY ST. ONGE OTR/L
Provider Business Mailing Address
First Line : 85 MIDDLE RD
Second Line :
City : CUMBERLAND
State : ME
Zip : 04021-3707
Country : US
Telephone Number : 207-829-8007
Fax Number : 207-829-8008
Provider Business Practice Location Address
First Line : 85 MIDDLE RD
Second Line :
City : CUMBERLAND
State : ME
Zip : 04021-3707
Country : US
Telephone Number : 207-829-8007
Fax Number : 207-829-8008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2008
Last Update Date : 11/13/2008

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Directions to “ HOLLY ST. ONGE OTR/L” Practice Location

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