Individual
MADISON MAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
10 BRUNSWICK AVE, EDISON, NJ 08817-2507
(732) 985-1500
Mailing address
54 GRASSMERE CT UNIT 8, FREEHOLD, NJ 07728-3934
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01319700
NJ
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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