SHELLY L VIDAS

BANGOR, ME
NPI1912002098
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: ME  OT790)
Enumeration Date2006-09-14
Last Update Date2007-07-08
Business Address
-- SHELLY L VIDAS OT
890 HAMMOND ST
BANGOR, ME 04401-4328
Phone number: 207-992-4042
Mailing Address
-- SHELLY L VIDAS OT
890 HAMMOND ST
BANGOR, ME 04401-4328
Phone number: 207-992-4042