Individual
LAURA BOUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
29 MAURICE DR, BRUNSWICK, ME 04011-3270
(207) 725-7495
Mailing address
533 E ELM ST, YARMOUTH, ME 04096-7513
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-2414
ME
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14130627
ASHA
—
Enumeration date
04/30/2015
Last updated
04/24/2020
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