Provider Demographics
NPI:1609887660
Name:METCALF, TODD (OTR/L)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:METCALF
Suffix:
Gender:M
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 1:60 VINCENT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3950
Mailing Address - Country:US
Mailing Address - Phone:207-712-5284
Mailing Address - Fax:
Practice Address - Street 1:1321 WASHINGTON AVE
Practice Address - Street 2:DEV. SERVICES OF PORTLAND, NORTHPORT PROFESSIONAL BLDG
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-3636
Practice Address - Country:US
Practice Address - Phone:207-712-5284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT 1418225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics