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Organization
NORTHERN MAINE SPEECH LANGUAGE PATHOLOGY SERVICES, INC.
Active
Organization
NORTHERN MAINE SPEECH LANGUAGE PATHOLOGY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUANITA BRISCOE (VICE PRESIDENT)
(207) 764-4498
Entity
Organization
Contact information
Practice address
4 BLAKE ST, PRESQUE ISLE, ME 04769-2427
(207) 764-4498
(207) 764-1912
Mailing address
PO BOX 308, PRESQUE ISLE, ME 04769-0308
(207) 764-4498
(207) 764-1912
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E002965
CHAMPUS
ME
Enumeration date
02/02/2007
Last updated
08/22/2020
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