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Organization
TALK SHOP
Active
Organization
TALK SHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAYE B. JEAN M.A., CCC-SLP (PRESIDENT)
(207) 933-6813
Entity
Organization
Contact information
Practice address
392 US ROUTE 202, NORTH MONMOUTH, ME 04265
(207) 933-6813
(207) 933-6726
Mailing address
PO BOX 55, 392 US RTE 202, N MONMOUTH, ME 04265-0055
(207) 933-6813
(207) 933-6726
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP844
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022170
ANTHEM BCBS ID
ME
05
—
133210000
—
ME
01
—
5097732
CIGNA ID
ME
01
—
5914716
AETNA ID
ME
01
—
MN3156
HPHC INSURANCE CO. ID
ME
Enumeration date
12/21/2006
Last updated
09/20/2012
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