Individual
MRS. CHARLENE MARIE SOUTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
163 SILVER ST, WATERVILLE, ME 04901-5813
(207) 877-2498
Mailing address
163 SILVER ST, WATERVILLE, ME 04901-5813
(207) 877-2498
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1188
ME
Other
Enumeration date
03/16/2010
Last updated
03/16/2010
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