Provider Demographics
NPI:1578680682
Name:COLE, CHRISTINA ROMAN (MSOTRL)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ROMAN
Last Name:COLE
Suffix:
Gender:F
Credentials:MSOTRL
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:ROMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOTRL
Mailing Address - Street 1:530 POND RD
Mailing Address - Street 2:
Mailing Address - City:STANDISH
Mailing Address - State:ME
Mailing Address - Zip Code:04084-5448
Mailing Address - Country:US
Mailing Address - Phone:207-892-1605
Mailing Address - Fax:
Practice Address - Street 1:300 SPRING ST
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-3915
Practice Address - Country:US
Practice Address - Phone:207-856-1230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1770225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist