Tonya Marie Goucher, AS, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Canaan, ME

NPI 1932431574 · NPPES record last updated Feb 8, 2010

Key facts

NPI
1932431574
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
OA1903 (ME)
Practice address
17 Crooked Creek Dr
Canaan, ME 04924-3354
Phone
(207) 399-8200
NPI assigned
Feb 8, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Associate of Science

State licenses

LicenseStateTypeSpecialty
OA1903MEMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OA1903 ME Yes

Addresses

Primary practice location

17 Crooked Creek Dr
Canaan, ME 04924-3354

Mailing address

PO Box 468
Skowhegan, ME 04976-0468
Phone (207) 474-7000

Other providers in Canaan, ME

All providers in Canaan, ME · Occupational Therapy Assistant in Maine

Sources for this page

Verify at the official NPI Registry.