Provider Demographics
NPI:1720612815
Name:HARRIGAN, MOLLY MONAHAN (OTR/L)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:MONAHAN
Last Name:HARRIGAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:JANE
Other - Last Name:MONAHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:48 MALLARD DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909
Mailing Address - Country:US
Mailing Address - Phone:207-319-2008
Mailing Address - Fax:
Practice Address - Street 1:48 MALLARD DR
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909
Practice Address - Country:US
Practice Address - Phone:207-203-9007
Practice Address - Fax:207-274-7012
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-27
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1215225X00000X
ME1146225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist