Provider Demographics
NPI:1629488234
Name:MARTIN, MAUREEN (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HIGHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5739
Mailing Address - Country:US
Mailing Address - Phone:207-873-0705
Mailing Address - Fax:207-692-2082
Practice Address - Street 1:7 HIGHWOOD ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5739
Practice Address - Country:US
Practice Address - Phone:207-873-0705
Practice Address - Fax:207-692-2082
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2775225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist