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Organization

PORTLAND PEDIATRIC SPEECH THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN BAHADORI M.A., CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(301) 802-8342
Entity
Organization

Contact information

Practice address
341 HIGHLAND AVE # 1, SOUTH PORTLAND, ME 04106-4510
(301) 802-8342
Mailing address
341 HIGHLAND AVE # 1, SOUTH PORTLAND, ME 04106-4510
(301) 802-8342

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP2317
ME

Other

Enumeration date
12/05/2016
Last updated
12/05/2016
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