Basic Information
| Provider Information | |||||||||
| NPI: | 1033745609 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCLEOD | ||||||||
| FirstName: | PRISCILLA | ||||||||
| MiddleName: | MOTLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 DAVIS POINT LN UNIT 1A | ||||||||
| Address2: | |||||||||
| City: | CAPE ELIZABETH | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041072628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077679773 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2 DAVIS POINT LN UNIT 1A | ||||||||
| Address2: | |||||||||
| City: | CAPE ELIZABETH | ||||||||
| State: | ME | ||||||||
| PostalCode: | 041072628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077679773 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2020 | ||||||||
| LastUpdateDate: | 02/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT3807 | ME | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.