Individual
MRS. LAURIE LEMIEUX MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Contact information
Practice address
75 W COMMERCIAL ST, NORTHEAST HEARING AND SPEECH, SUITE 205, PORTLAND, ME 04101-4797
(207) 874-1065
(207) 874-1068
Mailing address
75 W COMMERCIAL ST, NORTHEAST HEARING AND SPEECH, SUITE 205, PORTLAND, ME 04101-4797
(207) 874-1065
(207) 874-1068
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP445
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002731
ANTHEM BCBS
ME
05
—
258910099
—
ME
Enumeration date
01/29/2007
Last updated
10/23/2009
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