Most Relevant Information
Provider Data
| NPI Number: | 1003028994 |
| Provider Name: | CRYSTAL ANN GOODRICH OT |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | OT1010 |
Most Important Dates
| Enumeration Date: | 05/04/2007 |
| Last Updated: | 05/28/2024 |
Provider Practice Location
469 MAIN STREET
SUITE 102
SPRINGVALE
ME
04083
Practice Location Phone/Fax
| Phone: | 2073242888 |
| Fax: |
Provider Mailing Location
3 SCHOOL STREET
UNIT 204
BERWICK
ME
03901
Provider Mailing Phone/Fax
| Phone: | 2076168241 |
| Fax: |