Provider Demographics
NPI:1376099838
Name:BOLENDER, ALISON P
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:P
Last Name:BOLENDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:P
Other - Last Name:HANNUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 HASSON ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:ME
Mailing Address - Zip Code:04344-1613
Mailing Address - Country:US
Mailing Address - Phone:207-588-7692
Mailing Address - Fax:
Practice Address - Street 1:15 HASSON ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:ME
Practice Address - Zip Code:04344-1613
Practice Address - Country:US
Practice Address - Phone:207-588-7692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA3219225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics