Provider Demographics
NPI:1922799170
Name:BISBEE, BRYANNE ERICA (OT)
Entity Type:Individual
Prefix:
First Name:BRYANNE
Middle Name:ERICA
Last Name:BISBEE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 OAK POINT RD
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:ME
Mailing Address - Zip Code:04605-6217
Mailing Address - Country:US
Mailing Address - Phone:207-460-3760
Mailing Address - Fax:
Practice Address - Street 1:5 MAIN STREET
Practice Address - Street 2:
Practice Address - City:DEER ISLE
Practice Address - State:ME
Practice Address - Zip Code:04627
Practice Address - Country:US
Practice Address - Phone:207-348-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2584225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist