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Organization
ECSEL SPEECH & LANGUAGE SERVICES
Active
Organization
ECSEL SPEECH & LANGUAGE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA RUSSELL MUJICA M.A.; CCC-SLP (OWNER/ SPEECH-LANGUAGE PATHOLOGIST)
(207) 650-2271
Entity
Organization
Contact information
Practice address
41 PINE HILL RD, CASCO, ME 04015-4138
(207) 650-2271
Mailing address
41 PINE HILL RD, CASCO, ME 04015-4138
(207) 650-2271
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
SP795
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101130006
—
ME
Enumeration date
07/12/2010
Last updated
07/12/2010
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