Provider Demographics
NPI:1225296601
Name:OSTIGUY, DESIREE (MSW,OTR/L)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:
Last Name:OSTIGUY
Suffix:
Gender:F
Credentials:MSW,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:ME
Mailing Address - Zip Code:04530-1722
Mailing Address - Country:US
Mailing Address - Phone:508-776-3068
Mailing Address - Fax:
Practice Address - Street 1:348 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-1722
Practice Address - Country:US
Practice Address - Phone:508-776-3068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2636225X00000X
MA2153701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical