Provider Demographics
NPI:1114625449
Name:SENSORY THERAPY PLACE AND ASSOCIATES
Entity Type:Organization
Organization Name:SENSORY THERAPY PLACE AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAMARIL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:207-735-4625
Mailing Address - Street 1:41 ACME RD STE 4
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1543
Mailing Address - Country:US
Mailing Address - Phone:207-735-4625
Mailing Address - Fax:207-672-1822
Practice Address - Street 1:41 ACME RD
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1543
Practice Address - Country:US
Practice Address - Phone:207-735-4625
Practice Address - Fax:207-672-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty