Individual
MS. NANCY JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 CUMBERLAND PL, SUITE 108, BANGOR, ME 04401-5083
(207) 990-9000
(207) 945-8645
Mailing address
76 BALDWIN DR, BANGOR, ME 04401-1905
(207) 947-0428
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1129
ME
Other
Enumeration date
05/05/2007
Last updated
07/08/2007
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