Individual
BETH-ANNE KANECKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP, TSSLD
Contact information
Practice address
68 BISHOP ST, UNIT 1, ROOM 5, PORTLAND, ME 04103-2681
(646) 924-5111
Mailing address
68 BISHOP ST, UNIT 1, ROOM 5, PORTLAND, ME 04103-2681
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
020276-1
NY
Other
Enumeration date
09/07/2010
Last updated
08/16/2016
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