Provider Demographics
NPI:1205168093
Name:FARRAR, ERIN MARIE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:FARRAR
Suffix:
Gender:F
Credentials:MS, 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:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-0468
Mailing Address - Country:US
Mailing Address - Phone:207-474-7000
Mailing Address - Fax:
Practice Address - Street 1:72 RUTLAND RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04969-3247
Practice Address - Country:US
Practice Address - Phone:207-257-2332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1587225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist