Provider Demographics
NPI:1801147517
Name:ATHEY, DARCI (OTR/L)
Entity type:Individual
Prefix:
First Name:DARCI
Middle Name:
Last Name:ATHEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:DARCI
Other - Middle Name:
Other - Last Name:HAAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:SEARSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04974-0082
Mailing Address - Country:US
Mailing Address - Phone:541-852-6371
Mailing Address - Fax:
Practice Address - Street 1:105 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1811
Practice Address - Country:US
Practice Address - Phone:207-236-4197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT2630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist