Provider Demographics
NPI:1952126286
Name:FECTEAU, HANNAH J (COTA/L)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:J
Last Name:FECTEAU
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 1:126 OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:NORRIDGEWOCK
Mailing Address - State:ME
Mailing Address - Zip Code:04957-4023
Mailing Address - Country:US
Mailing Address - Phone:207-465-5260
Mailing Address - Fax:
Practice Address - Street 1:10 HIGH ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1865
Practice Address - Country:US
Practice Address - Phone:207-424-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA2226224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant