Individual
JERUSHA MADALINE CHICOINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
75 W COMMERCIAL ST, PORTLAND, ME 04101-4797
(207) 874-1065
Mailing address
75 W COMMERCIAL ST, PORTLAND, ME 04101-4797
(207) 874-1065
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1320
ME
Other
Enumeration date
04/06/2007
Last updated
10/19/2009
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