Individual
PAIGE ANNE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
210 14TH ST, BANGOR, ME 04401
(207) 945-3254
Mailing address
210 14TH ST, BANGOR, ME 04401-4446
(207) 945-3254
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1264
ME
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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