Provider Demographics
NPI:1700540887
Name:STIMPSON, MEGAN CHRISTY (COTA/L)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:CHRISTY
Last Name:STIMPSON
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 1:163 JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:MECHANIC FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04256-5911
Mailing Address - Country:US
Mailing Address - Phone:207-713-2056
Mailing Address - Fax:
Practice Address - Street 1:102 CAMPUS AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6019
Practice Address - Country:US
Practice Address - Phone:207-777-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA4192224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant