Individual
EMMA R PELLETIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 W COMMERCIAL ST STE 205, PORTLAND, ME 04101-4799
(207) 874-1065
Mailing address
63 BOARDLEY RD, SANDWICH, MA 02563-2602
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
ST3034
ME
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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