Provider Demographics
NPI:1659645893
Name:SAWYER, AARON J (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:J
Last Name:SAWYER
Suffix:
Gender:M
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2647
Mailing Address - Country:US
Mailing Address - Phone:207-619-9263
Mailing Address - Fax:207-799-8346
Practice Address - Street 1:127 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2647
Practice Address - Country:US
Practice Address - Phone:207-619-9263
Practice Address - Fax:207-799-8346
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA2424224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant