Individual
MIRANDA BEAUDOIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
340 ALLEN AVE, PORTLAND, ME 04103-3804
(207) 878-0530
(207) 878-0546
Mailing address
539 AUBURN ST, PORTLAND, ME 04103-6006
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PR5642
ME
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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