Individual
MRS. MARY CLARE CLIFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
133 LIBBY RD, POWNAL, ME 04069-6332
(207) 558-2058
Mailing address
133 LIBBY RD, POWNAL, ME 04069-6332
(207) 462-2058
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP966
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043865
ANTHEM BLUE CROSS
ME
05
—
233420000
—
ME
05
—
233420099
—
ME
01
—
2875611
CIGNA
ME
01
—
7892683
AETNA
ME
Enumeration date
04/03/2007
Last updated
04/09/2024
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