Provider Demographics
NPI:1447558135
Name:HANCOCK, BETHANY JANE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:JANE
Last Name:HANCOCK
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 1:767 MAIN STREET, 1A
Mailing Address - Street 2:CENTRAL LINCOLN COUNTY SCHOOL SYSTEM AOS 93
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543
Mailing Address - Country:US
Mailing Address - Phone:207-563-3044
Mailing Address - Fax:
Practice Address - Street 1:559 MAIN ST
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543-4660
Practice Address - Country:US
Practice Address - Phone:207-563-3091
Practice Address - Fax:207-563-6974
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1262225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics