Provider Demographics
NPI:1750424032
Name:DIONNE-MICHAUD, CHANTEL LYNN (MS, OTRL)
Entity type:Individual
Prefix:MS
First Name:CHANTEL
Middle Name:LYNN
Last Name:DIONNE-MICHAUD
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MACKWORTH ISLAND
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105
Mailing Address - Country:US
Mailing Address - Phone:207-781-6233
Mailing Address - Fax:
Practice Address - Street 1:1 MACKWORTH IS
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1900
Practice Address - Country:US
Practice Address - Phone:207-781-6233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2363225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist