Provider Demographics
NPI:1649860743
Name:GREENWOOD, TERRI (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 STONEWALL DRIVE
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:ME
Mailing Address - Zip Code:04253
Mailing Address - Country:US
Mailing Address - Phone:207-330-9287
Mailing Address - Fax:
Practice Address - Street 1:15 STRAWBERRY AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5941
Practice Address - Country:US
Practice Address - Phone:207-777-7740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist