Emily Odermann

Individual provider Active NPI Occupational Therapist · Old Town, ME

NPI 1609280379 · NPPES record last updated Apr 30, 2020

Key facts

NPI
1609280379
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT2858 (ME)
Practice address
240 Main St Ste 4
Old Town, ME 04468-1482
Phone
(207) 827-4100
NPI assigned
Jun 20, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
OT2858MEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Motion Physical Therapy, LLC Past
since Dec 12, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT2858 ME Yes

Addresses

Primary practice location

240 Main St Ste 4
Old Town, ME 04468-1482

Mailing address

165 Chamberlain St
Brewer, ME 04412-1903
Phone (207) 450-3792

Other providers in Old Town, ME

All providers in Old Town, ME · Occupational Therapist in Maine

Sources for this page

Verify at the official NPI Registry.