Provider Demographics
NPI:1386711562
Name:NELSON, MAREN A (MA, OTL)
Entity type:Individual
Prefix:
First Name:MAREN
Middle Name:A
Last Name:NELSON
Suffix:
Gender:F
Credentials:MA, OTL
Other - Prefix:
Other - First Name:MAREN
Other - Middle Name:NELSON
Other - Last Name:NAGEM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 LONGWOODS RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2608
Mailing Address - Country:US
Mailing Address - Phone:207-767-9773
Mailing Address - Fax:
Practice Address - Street 1:2 DAVIS POINT LN UNIT 1A
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2628
Practice Address - Country:US
Practice Address - Phone:207-767-9773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT446225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist