Provider Demographics
NPI:1073082574
Name:GIRARD, AERICA (OTR/L)
Entity Type:Individual
Prefix:
First Name:AERICA
Middle Name:
Last Name:GIRARD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:ME
Mailing Address - Zip Code:04352-3309
Mailing Address - Country:US
Mailing Address - Phone:207-491-7766
Mailing Address - Fax:
Practice Address - Street 1:107 GIBBS MILL RD
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:ME
Practice Address - Zip Code:04253-3067
Practice Address - Country:US
Practice Address - Phone:207-897-3355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2181225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist