Provider Demographics
NPI:1851410039
Name:WRIGHT, KRISTIANA (OTRL)
Entity Type:Individual
Prefix:
First Name:KRISTIANA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 RIVERSIDE ST
Mailing Address - Street 2:APT 313
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-5916
Mailing Address - Country:US
Mailing Address - Phone:207-590-8226
Mailing Address - Fax:
Practice Address - Street 1:361 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1345
Practice Address - Country:US
Practice Address - Phone:207-781-4830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2033225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics