Provider Demographics
NPI:1649994260
Name:THARP, BRIDGET MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:MARIE
Last Name:THARP
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:MARIE
Other - Last Name:SLATTERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:31 WOODSPELL RD
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-8223
Mailing Address - Country:US
Mailing Address - Phone:319-350-0409
Mailing Address - Fax:
Practice Address - Street 1:10 TRAILS END RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-7307
Practice Address - Country:US
Practice Address - Phone:319-350-0409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT3579225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist