Provider Demographics
NPI:1861642217
Name:KENT, RHONDA LYNN (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:RHONDA
Middle Name:LYNN
Last Name:KENT
Suffix:
Gender:F
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:P.O. BOX 85
Mailing Address - Street 2:
Mailing Address - City:CORINNA
Mailing Address - State:ME
Mailing Address - Zip Code:04928
Mailing Address - Country:US
Mailing Address - Phone:207-938-2564
Mailing Address - Fax:
Practice Address - Street 1:335 STILLWATER AVE.
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-947-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA1843224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME11859864-01OtherWASSAU BENEFITIS